• 대한기관식도과학회지
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• 제1권1호
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• pp.151-158
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• 1995

Anaplastic carcinoma of thyroid gland account for no more than 10% of thyroid cancer, but it shows extremely poor prognosis. The purpose of this study is to review the outcome of patients with anaplastic carcinoma over the span of 5 years and to determine the patterns of clinical presentation, age, sex and other possible prognostic variables. We analyzed 30 cases of anaplastic carcinoma retrospectively from 1991 to 1995. There were 14 men and 16 women. There age ranged 33 to 75 years with a mean of 61.0 years. Sixteen patients presented with transformationqr of well differentiated carcinoma to anaplastic carcinoma, 1 with rapid in-crease in the size of long standing goiter, 8 with rapidly growing neck mass and 4 with meta static disease. Twenty-eight patients(93.3%) showed cervical lymphnode metastasis at presentation and twenty three patients(76.6%) showed laryngotracheal invasion. Nine patients (30.3%) showed distant metastasis. Treatment modalities included surgical resection, external irradiation, radioactive iodine and systemic chemotherapy. At decision making of treatment plan, we considered completeness of initial surgery, uptake rate of whole body radioactive io-dine scan, locoregional progression and distant metastasis. The median survival was 6.8 months and three cases survived beyond 12 months.

• 한국간호교육학회지
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• 제26권4호
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• pp.402-411
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• 2020

Purpose: The purpose of this study is to explore the trends of research related to ethical topics in Korean nursing students. Methods: A total of 131 articles that were published from 2000 to 2020 were analyzed and summarized according to publishing type, research design, subject, data analysis method, main research topic, research variables and instrument. Results: Most studies were journal articles (93.9%) and their most frequent research design was survey (75.7%). The research subjects covered all grades (35.1%) or they were divided between clinical nursing practicum (29.8%) or not (21.4%). The main research topics were biomedical ethics, ethical values, moral judgment and ethics education. Recently, ethical decision making and practical ability in nursing practice were reported. The instruments for measuring variables were limited and the same tools were used several times. Conclusion: Based on the findings of this study, it is suggested that the selection of various research topics and the application of research methods related to ethics for nursing students will continue in response to rapidly changing social phenomena in the future. In particular, it is necessary that research related to ethical and practical ability as well as ethical attitudes and perceptions of nursing students be actively carried out.

• 간호행정학회지
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• 제8권3호
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• pp.411-430
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• 2002

Purpose : This study was to develop Nursing Process Model of abdominal surgery patient using nursing diagnoses of NANDA, Nursing Interventions Classification(NIC), and Nursing Outcomes Classification(NOC). Method : The data in database were collected from nursing records in sixty patients with abdominal surgery admitted in a university hospital and open questionnaires of thirteen nurses. Systematic nursing process resulting from each nursing diagnoses, most common, was developed by the statistical analysis through database query from clinical database of abdominal surgery patients. Result : 51 nursing diagnoses were identified in abdominal surgery patients. The most commonly occurred nursing diagnoses were Pain, Risk for Infection, Sleep Pattern Disturbance, Hyperthermia, Altered Nutrition: Less Than Body Requirements in order. The linkage lists of NANDA to NIC and NANDA to NOC, and the nursing activities according to nursing diagnoses of abdominal surgery patients were identified in unit. Conclusion : Nursing Process of abdominal surgery patients was comprised of core nursing diagnoses, core nursing interventions, core nursing outcomes which provides the most reliable data in unit and could make nurses facilitate nursing process easily without full consideration of knowledge about nursing language classification system. Therefore, it could support nurses' decision making and recording of nursing process especially in the computerized patient record system if unit nursing process model using standardized nursing language system which contains of their own core nursing process data was developed.

• 간호행정학회지
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• 제17권3호
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• pp.336-348
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• 2011

Purpose: This methodological study was done to develop a telephone consultation algorithms and practice guidelines for patient discharged with ophthalmic diseases. Methods: The ophthalmic problems of the patients were identified and expert knowledge on managing the problems was acquired. Algorithms and practice guidelines were developed based on the expert knowledge. The content validity of algorithms and practice guidelines was evaluated by the experts. Results: The preliminary algorithms and practice guidelines were developed from 60 detailed signs and symptoms and 45 nursing interventions. The experts agreed that 57 detailed signs and symptoms linked with nursing interventions were valid, with the content validity index over 80%. Meeting with nurse experts and ophthalmologists was convened to review the rest of the 3 detailed signs and symptoms linked with nursing interventions. Finally, 60 detailed signs and symptoms and 46 nursing interventions were confirmed. Conclusion: This study suggests that the algorithms and practice guidelines are effective decision-making tools and utilization of these algorithms and practice guidelines is expected to improve the quality of clinical nursing and patient satisfaction.

• 가정∙방문간호학회지
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• 제18권1호
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• pp.48-57
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• 2011

Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권5호
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• pp.303-312
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• 2020

Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

• Journal of Electrical Engineering and Technology
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• 제9권3호
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• pp.1060-1071
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• 2014

Signals of the Electroencephalogram (EEG) can reflect the electrical background activity of the brain generated by the cerebral cortex nerve cells. This has been the mostly utilized signal, which helps in effective analysis of brain functions by supervised learning methods. In this paper, an approach for improving the accuracy of EEG signal classification is presented to detect epileptic seizures. Moreover, Independent Component Analysis (ICA) is incorporated as a preprocessing step and Short Time Fourier Transform (STFT) is used for denoising the signal adequately. Feature extraction of EEG signals is accomplished on the basis of three parameters namely, Standard Deviation, Correlation Dimension and Lyapunov Exponents. The Artificial Neural Network (ANN) is trained by incorporating Levenberg-Marquardt(LM) training algorithm into the backpropagation algorithm that results in high classification accuracy. Experimental results reveal that the methodology will improve the clinical service of the EEG recording and also provide better decision making in epileptic seizure detection than the existing techniques. The proposed EEG signal classification using feed forward Backpropagation Neural Network performs better than to the EEG signal classification using Adaptive Neuro Fuzzy Inference System (ANFIS) classifier in terms of accuracy, sensitivity, and specificity.

• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.371-376
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• 2009

In this article, we reviewed the literature on risk assessment (RA) models with and without molecular genomic markers and the current utility of the markers in the pharmacogenetic field. Epidemiological risk assessment is applied using statistical models and equations established from current scientific knowledge of risk and disease. Several papers have reported that traditional RA tools have significant limitations in decision-making in management strategies for individuals as predictions of diseases and disease progression are inaccurate. Recently, the model added information on the genetic susceptibility factors that are expected to be most responsible for differences in individual risk. On the continuum of health care, from diagnosis to treatment, pharmacogenetics has been developed based on the accumulated knowledge of human genomic variation involving drug distribution and metabolism and the target of action, which has the potential to facilitate personalized medicine that can avoid therapeutic failure and serious side effects. There are many challenges for the applicability of genomic information in a clinical setting. Current uses of genetic markers for managing drug therapy and issues in the development of a valid biomarker in pharmacogenetics are discussed.

• Experimental and Molecular Medicine
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• 제50권12호
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• pp.10.1-10.11
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• 2018

Cancer growth and progression are associated with immune suppression. Cancer cells have the ability to activate different immune checkpoint pathways that harbor immunosuppressive functions. Monoclonal antibodies that target immune checkpoints provided an immense breakthrough in cancer therapeutics. Among the immune checkpoint inhibitors, PD-1/PD-L1 and CTLA-4 inhibitors showed promising therapeutic outcomes, and some have been approved for certain cancer treatments, while others are under clinical trials. Recent reports have shown that patients with various malignancies benefit from immune checkpoint inhibitor treatment. However, mainstream initiation of immune checkpoint therapy to treat cancers is obstructed by the low response rate and immune-related adverse events in some cancer patients. This has given rise to the need for developing sets of biomarkers that predict the response to immune checkpoint blockade and immune-related adverse events. In this review, we discuss different predictive biomarkers for anti-PD-1/PD-L1 and anti-CTLA-4 inhibitors, including immune cells, PD-L1 overexpression, neoantigens, and genetic and epigenetic signatures. Potential approaches for further developing highly reliable predictive biomarkers should facilitate patient selection for and decision-making related to immune checkpoint inhibitor-based therapies.

• Journal of Acupuncture Research
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• 제36권1호
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• pp.1-11
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• 2019

Models of traditional Chinese medicine (TCM) are still difficult to grasp from the view of a Western-cultural background. For proper integration into science and clinical research, it is vital to think "out of the box" of classical sciences. Modern sciences, such as quantum physics, system theory, and information theory offer new models, that reveal TCM as a method to process information. For this purpose, we apply concepts of information theory to propose a "Chinese black box model," that allows for a non-deterministic, bottom-up approach. Considering a patient as an undeterminable complex system, the process of getting information about an individual in Chinese diagnostics is compared to the input-process-output principle of information theory and quantum physics, which is further illustrated by Wheeler's "surprise 20 questions." In TCM, an observer uses a decision-making algorithm to qualify diagnostic information by the binary polarities of "yang" (latin activity) and "yin" (latin structivity) according to the so called "8 principles" (latin 8 guiding criteria). A systematic reconstruction of ancient Chinese terms and concepts illuminates a scattered scientific method, which is specified in a medical context by Latin terminology of the sinologist Porkert [definitions of the Latin terms are presented in Porkert's appendix [1] (cf. Limitations)].