• Journal of Chest Surgery
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• 제27권10호
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• pp.850-853
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• 1994

Open lung biopsy was performed in thirty patients for the diagnosis and staging evaluation of interstitial lung disease during the period from January 1987 until December 1992. The age of the patients ranged from 14 to 71 years [mean 48 years], and the patients consisted of 14 males and 16 females. Preoperative FEV1`s were from 0.80 liter to 3.88 liters [mean 1.66]. Other non-invasive diagnostic studies such as PCNA, bronchoalveolar lavage, TBLB, and gallium scan were also done in addition to X-ray and high-resolution chest CT. Tweaty-eight were correctly diagnosed and 2 cases were not [diagnostic yield rate 93.3%]. Among the 28 cases,pathologic diagnosis influenced further treatment regimens and prognostic expectations in 23 cases [82.1%]. The diagnostic non-invasive studies other than open lung biopsy yielded a correct diagnosis without staging only in 5 cases. There was no mortality and only one complication, ARDS ; however, the patient recovered after 5 days ventilator support. Open lung biopsy, which is the gold standard for the diagnosis and staging evaluation of interstitial lung disease can be done safely and has value in clinical decision making. Also knowledge of the involvement of the lesion is important for proper selection of the biopsy site.

• 한국치위생학회지
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• 제14권5호
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• pp.609-615
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• 2014

Objectives : In most developed countries there has been a substantial decrease in the prevalence of dental caries in children of 12 years old over the past 40 years. This change in epidemiology highlights the importance of preventive management in dentistry. For successful management of early caries lesions, it is essential to detect and assess the pathological changes of dental caries. Therefore, the purpose of this study was to investigate the overview of International Caries Detection and Assessment System(ICDAS) criteria for the detection and assessment of early caries lesions by literature reviews. Methods : The author reviewed the MEDLINE search by the key words of 'caries assessment', 'caries detection', 'caries measurement', and 'ICDAS'. Results : This literature review provided an overview of International Caries Detection and Assessment System(ICDAS) criteria for the detection and assessment of early caries lesions. This article showed the principles, concept, and primary caries detection criteria of the ICDAS. The ICDAS can macroscopically measure the enamel surface changes and potential histological depth of caries lesions by the surface characteristics of the teeth. The ICDAS criteria allow researchers and clinicians to choose the stage of dental caries and characteristics for assessment. Conclusions : ICDAS can be an adjunct method to clinical decision making and preventive treatment planning.

• 여성건강간호학회지
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• 제12권2호
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• 대한의용생체공학회:의공학회지
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• 제38권3호
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• pp.89-94
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• 2017

In order to improve national competitiveness through technological research and development, the government puts in R&D budget every year and manages to improve the R&D results. Accordingly, various R&D project management methods have applied for successful advancement of technology and product. TRL is a measurement system developed by NASA to assess the maturity of technology since the 1970s. To apply medical device, the characteristics such as regulation, clinical trials are considered as a significant influence. In this study, we would like to derive PMI(performance measures index) for medical device R&D projects by using TRL and stage-gate model. As a result of this study, it is possible to use the PMI for decision making and evaluation in the R&D projects and believed that the objectivity can be ensured by the approval or certification of regulatory authority.

• 영어어문교육
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• 제17권4호
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• pp.1-22
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• 2011

Little has been known about the process of the language teacher professional development. The present study aims to investigate an assumption that anybody who has subject matter knowledge will be a good language teacher. A teacher with rich linguistic knowledge started to question the effectiveness of his online class. The teacher, in collaboration with a teacher trainer, became involved in the critical examination of his online class, seeking for more effective ways of teaching. The trainer provided the teacher with clinical supervision, which is characterized as developmental, collaborative, non-judgemental, interactive, and teacher-centered. The data collected at the multi-facets of the online teaching shows how the process of the teacher's decision-making became principled on the basis of recent developments in English language teaching, and how the teacher has gained pedagogical knowledge through reflection upon his teaching. The feedback from the students reveals that such teacher professional development is beneficial to student learning. These findings suggest that language teacher's professional development can take place when they are engaged in reflective teaching and classroom investigation. It is also suggested that the process of teacher development can be enhanced through collaborative supervision with trust, openness and congeniality between parties involved.

• 재활간호학회지
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• 제18권2호
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• pp.75-87
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• 2015

Purpose: The purpose of this study was to develop a home-based self-management support intervention (SMSI) for enhancing pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) in Korea. Methods: This methodological study was conducted by following these 4 steps: constructing the preliminary draft of a home-based SMSI from existing recommendation and a literature review on PR and self-management interventions; testing content validity with 6 experts in COPD; exploring clinical applicability of the intervention by applying it to 4 COPD patients; determining the final intervention. Results: The final intervention included 4 components and contents identified from the literature review as essentials for self-management of COPD patients: education; exercise training and practice including breathing, muscle strengthening and aerobic exercises; cognitive behavioral strategies including informative self-decision making, collaborative goal setting and supportive advice; and action planning for exacerbation. The intervention was designed to be run by a trained nurse and had 8 weekly sessions consisting of three 60-minute face-to-face sessions and five 20-minute phone-call sessions. Conclusion: The intervention developed in this study incorporates essential components of self-management, i.e. action plan and cognitive behavioral strategies, and will contribute to enhancing and maintaining effects of PR by increasing self-management in COPD patients.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
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• pp.3-26
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• 1996

Epidemiology and preventive medicine are changing together with Population and health and with ever expanding medical and non medical technologies. New technologies make epidemiology methodologically more sophisticated, but such advances risk overshadowing epidemiology's most important role: raising questions, providing answers, and helping the medical decision-making at ail levels of prevention. Epidemiology also plays a major role in the evaluation of new and other technologies whose effectiveness is poorly known. Epidemiological approaches, methods, techniques, and interpretations are widely used in new and rapidly expanding fields of medicine: research evaluation and synthesis (meta-analysis), establishment of guidelines for clinical preventive practices, new medical technology assessment, guidelines for national and international health policies, evidence-based medicine, outcomes research and disease management ('population-based' medicine and quality of care improvement). In the nearest future, infectious and noninfectious diseases may cease to be almost the sole subjects of epidemiology and they may share their place with other mass phenomena of the next millennium, such as medical practices and care, or political, social and economic actions and their consequences. Not only will primary, secondary, and tertiary Prevention will remain in the epidemiological mainstream, but health protection and health promotion will require perhaps a redefinition of epidemiology in these domains. Epidemiology and preventive medicine are both subjects of medical ethics and dilemma for right choices.

• 보건행정학회지
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• 제28권3호
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• pp.263-271
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• 2018

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.110-116
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• 2016

Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

• 대한두경부종양학회지
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• 제17권1호
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• pp.38-41
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• 2001

Background and Objectives: Thyroid nodules can be diagnosed by FNAB, neck sonography, CT scan, or frozen section with relative accuracy. But some cases, which show no malignancy with those methods, are proved differentiated carcinomas on permanent sections. These false negative results of those diagnostic methods pose difficulties in the surgeon's decision-making process. We analyzed completion thyroidectomies retrospectively in order to make a treatment guideline for thyroid nodules. Materials and Methods: During the last six years, we performed 243 thyroid lobectomies, no evidence of malignancy with preoperative or intraoperative diagnostic methods at the Department of Otolaryngology-Head and Neck Surgery, Ansan and Anam Korea University Hospital. Among these cases, 23 patients (male 6, female 17, mean age 33.4 year old) were proved differentiated thyroid carcinomas on permanent section and we performed completion thyroidectomies. Results: Preoperative FNAB showed seven cases of nodular hyperplasia, 11 cases of follicular adenoma, and five cases of inadequate specimen. Among total 15 cases on frozen section, five cases were nodular hyperplasias, and 10 cases were follicular adenomas. Pathologic results of the permanent section were six cases of papillary cell carcinoma and 17 cases of follicular cell carcinoma. Completion thyroidectomy was performed on all these cases. Conclusion: FNAB and frozen section cannot be sufficient to make the diagnosis of thyroid nodule, we consider that completion thyroidectomy should be performed at the moment with malignant evidence on permanent section.