• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.652-664
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• 2022

The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.95-103
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• 2022

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A one-group pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z= -4.89, p< .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t= -3.19, p= .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p< .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes (± 1 hour 52 minutes) to 3 hours 1 minute (± 1 hour 41 minutes) (t= 2.51, p= .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% (χ²= 6.90, p= .009). Conclusion: The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.74-83
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• 2022

Objective: There is a growing movement to introduce Patient-Reported Outcome (PRO) to clinical settings. This study aimed to investigate the routine use of PRO in tertiary hospital clinical settings. Methods: From January 2016 to December 2018, the usage status of Patient-Reported Outcome Measures (PROMs) submitted to the electronic medical record of a tertiary hospital clinical setting was investigated. Descriptive analysis was conducted to investigate the usage status of PROMs by 42 departments. Also, the most frequently used PROMs by departments, the purpose of measurement, the use rate of verified PROMs were investigated. Results: The PROMs accounted for 66% (98) of the 148 Instruments. Of the 98 PROMs, 64% (63) were using a validation Korean version of PROMs. Only about 1% of total outpatient visits applied PROMs, and among them, it was frequently used in urology (13%), orthopedics (8%), and otolaryngology (5%). The use rate of the validated PROMs was found to be 64%. Conclusions: The use of PROMs in domestic clinical settings was found to be very limited and frequently used only in specific departments. It is essential to use a PROMs that has been validated according to guidelines, as the use of validated PROMs will provide beneficial information to health professionals and also for the patient health improvement by objectively measuring the patient's health status.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.3
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• pp.7-16
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• 2022

Purpose: This study aims to establish the basic directions of the modular airborne infection isolation(AII) ward. Considering a specific function and purposed use as a modular AII ward, it is a chance to derive an address of current modular technology by overview the limitation and improvement of the existing modular architecture. Methods: In addition to the literature analysis on the configuration system of mobile hospitals, research cases on the operational effectiveness of the domestic and foreign mobile construction systems are analyzed. Results: In order to meet the various and strict space guidelines of the AII ward and a chance to improve limitations of uniformed existing modulars, AII modular the negative pressurized care setting should be minimized a structural restriction for reflecting its system on a architectural plan. For this unique requirements, it could be possible to apply various space boxes called infill box which needs to secure a large-scale space. So, a rahmen structure system could be adaptable for this purpose. A dead space between beams of the rahmen structure is to be used for MEP installation. Partial separation, dismantling, and repair should be possible by separating the MEP and infill box from the structure. The infill box must keep 3.5m width under the current Road Traffic Act. Implications: It is necessary to utilize and develop an improved construction method that can reduce the problems of existing steel modular and PC modular.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.9-22
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• 2023

Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren's syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

• Advances in environmental research
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• v.11 no.1
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• pp.31-38
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• 2022

The current observational epidemiological study analyzed blood lead levels (BLLs) in occupationally exposed workers from Riyadh region, Saudi Arabia and correlated them with the alterations in the differential cell populations of the WBC panel (lymphocytes [Lym %], mixed [Mid %] cells, and neutrophils [Neu %]). In addition, we examined the effect of confounding factors and their relation to BLLs. BLLs were estimated using the LeadCare II analyzer and hematological parameters using the ADVIA 120 analyser. An inferential analysis was conducted to detect association between the observations and the subjects' clinical characateristics. A total of 132 male subjects were included in the final analyses. Based on CDC guidelines, the subjects were categorized as Group I (BLL <10 ㎍/dL; n=118) or Group II (BLL >10 ㎍/dL; n=14) with average BLLs of 4.4 ㎍/dL and 18.1 ㎍/dL, respectively (p <0.0001). The percentages of Mid cells (p <0.0001) and neutrophils (p=0.048), were significantly altered in subjects with High BLL. A regression analysis indicated that subjects > 50 years of age had significantly higher BLLs (53.2 ㎍/dL) than younger age sub-groups (p <0.0001). Age, education, and profession were significant predictors for lead toxicity. Pb exposure is a major public health issue in Saudi Arabia and calls for further investigations on the cellular and molecular effects on hematological system.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.32-43
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• 2023

Purposes: This research is conducted to identify main features and trends of mission, vision and core values in Korean tertiary general hospitals by using text-mining. Methodology: For the study, 45 mission, 112 vision and 190 core values are collected from 45 tertiary general hospitals' homepages in 2022 and use word frequency analysis and Leyword co-occurrence analysis. Findings: In the tertiary general hospitals' mission, there are high frequency words such as 'health', 'humanity', 'medical treatment', 'education', 'research', 'happiness', 'love', 'best', 'spirit', and mission mainly includes the content of contributing humanity's health and happiness with these words. In case of vision, high frequency words are 'hospital', 'medical treatment', 'research', 'lead', 'trust', 'centered', 'patient', 'best', 'future'. By using these words in vision, it represents the definition and characteristics of vision such as ideal organizations in the future, goals and targets. As a result of the Leyword co-occurrence analysis, vision includes the content of 'high-tech medical treatment', 'special care for patients', 'leading education and research', 'the highest trust with customer', 'creative talents training'. -astly, the high frequency word-pairs in core values are 'social distribution', 'innovation pursuit', 'cooperation and harmony', and it defines standards of behavior for organizations. Practical Implication: To correct the problems of vision, mission and core values from findings, firstly, it needs for Korean tertiary general hospitals to use the words that can explain organization's identity and differentiate others in their mission. Secondly, considering strengthening the role of hospitals in their community and the importance of members in organizations, it is necessary to establish vision with considering community and members to activate vision effectively. Thirdly, because there are no specific guidelines of establishing mission, vision and core values for healthcare organizations, this research concepts and results could be utilized when other organizations establish mission, vision and core values.

• Korean Journal of Exercise Nutrition
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• v.16 no.2
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• pp.113-122
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• 2012

This study assessed the amount of energy consumed and fat deposition after endurance training in order to review the effect of 4-week endurance exercise on resting metabolic rate of a mouse during and after exercise and the effect of exercise. A total of 19 seven-week-old ICR male mice were used as the study subject. Those mice were divided into sedentary group (Sed) and trained group (Tr) after a week of environment adaption. The Tr group was trained with endurance exercise five times a week for four weeks. Weight and the amount of food intake were daily weighed and resting metabolic rate and metabolic rate after exercise were assessed before starting exercise and on the fourth week after training. Metabolic rate during exercise were measured four weeks after training. At the end of breeding period, statistically significant difference was shown in weights of trained and sedentary groups (p < 0.05). During a resting period, no significant difference was shown in oxygen intake, respiratory exchange ratio, and the amount of carbohydrate and fat oxidized. Moreover, no significant difference was shown in excess post-exercise oxygen consumption (EPOC) of an hour period after training. In contrast, the maximal oxygen uptake (VO₂ max) was approximately 11.1% higher in trained group after training compare to before. However, there was no significant difference in respiratory exchange ratio and carbohydrate and fat oxidization. During exercise, oxygen uptake, carbon dioxide production, and respiratory exchange ratio in energy metabolism during exercise showed no significant difference. However, significant difference was exhibited in the amount of fat oxidized in both groups. Summing up those results, endurance exercise could be concluded to be effective in weight control. However, weight loss is thought to be resulted from increase in fat oxidization during exercise unlike the conclusion made from previous studies where weight loss is prominently influenced by energy metabolism during a resting period and increased fat oxidation during post-exercise recovery. All experimental procedures were carried out at the Animal Experiment Research Center of Konkuk University. This study was conducted in accordance with the ethical guidelines of the Konkuk University Institutional Animal Care and Use Committee.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.