• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.781-784
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• 2016

The Plurinational State of Bolivia (Bolivia) has a high incidence rate of gallbladder cancer (GBC). However, the genetic and environmental risk factors for GBC development are not well understood. We aimed to assess whether or not cytochrome P450 (CYP1A1), glutathione S-transferase mu 1 (GSTM1), theta 1 (GSTT1) and tumor suppressor protein p53 (TP53) genetic polymorphisms modulate GBC susceptibility in Bolivians. This case-control study covered 32 patients with GBC and 86 healthy subjects. GBC was diagnosed on the basis of histological analysis of tissues at the Instituto de Gastroenterologia Boliviano-Japones (IGBJ); the healthy subjects were members of the staff at the IGBJ. Distributions of the CYP1A1 rs1048943 and TP53 rs1042522 polymorphisms were assayed using PCR-restriction fragment length polymorphism assay. GSTM1 and GSTT1 deletion polymorphisms were detected by a multiplex PCR assay. The frequency of the GSTM1 null genotype was significantly higher in GBC patients than in the healthy subjects (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.03-5.37; age-adjusted OR, 3.53; 95% CI, 1.29-9.66; age- and sex-adjusted OR, 3.40; 95% CI, 1.24-9.34). No significant differences were observed in the frequencies of CYP1A1, GSTT1, or TP53 polymorphisms between the two groups. The GSTM1 null genotype was associated with increased GBC risk in Bolivians. Additional studies with larger control and case populations are warranted to confirm the association between the GSTM1 deletion polymorphism and GBC risk suggested in the present study.

• 대한한의학회지
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• 제42권3호
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• pp.1-8
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• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.318-323
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• 2017

Objectives: Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. Materials and Methods: We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Results: Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. Conclusion: This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

• 의학교육논단
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• 제14권1호
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• pp.37-49
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• 2012

The main purpose of this study is to examine the improvement and discourse of the medical education system in Korea since 1990. In particular, this study, focusing on the graduate medical education system initiated in 2002, has explored the discussions that led to the system's establishment and what the context of those discussions. To meet this objective, this study analyzed research report related to the medical education system authored by members of the government and medical community, suggestions to the government, discussion materials, and data with regard to the Medical (Dental) Education Eligibility Test. The improvement of the medical education system in Korea has been an important issue in education reform by the expansion of the number of years of higher education, the requirements for increased levels of professional knowledge by improving public educational standards, and the basic formation policy of higher education consisting of graduate school, special graduate school, and professional graduate school. Nevertheless, the views of the government and the medical community on improving medical education system have made an obvious difference. This was due to different aims about how to improve the medical education system and different perception of the degree and medical education system. The medical community at least tended to prefer the status of academic positions over professional positions. The policy of medical education for people with a bachelor's degree which was introduced in 2002 spread to many colleges of medicine based on the government's administrative and financial support policy. Even so, the absence of accompanying policy by the relevant government agencies and department of education, which could have ensured the success of the system, has led to continued debate. In conclusion, without a consistent and persistent government policy, the graduate medical education system has led to confusion in many medical institutions. Above all, an evidence-based policy decision and policy approach based on a long-term perspective are necessary in order to improve the medical education system.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5196-5205
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• 2012

목적 : 본 연구는 간호사와 치위생사의 환자안전문화에 대한 인식수준을 파악하기 위해 시행되었다. 방법 : 2010년 9월부터 12월까지 부산, 경남지역의 병원에 종사하는 간호사와 치위생사 399명을 대상으로 환자안전문화 인식 도구를 사용하여 설문조사가 시행되었으며, 수집된 자료는 SPSS 프로그램을 사용하여 평균과 표준편차, t-test와 ANOVA, Scheffe test, spearman 상관관계분석을 시행하였다. 결과 : 환자안전문화에 대한 인식을 조사한 결과, 간호사는 3.48점, 치위생사는 3.51점으로 나타났다. 세부 영역에서 차이를 보인 항목은, '부서내 안전문화에 대한 인식' 영역 중 '직원배치'(t=2.841, p<.01), '직속상관 관리 태도'(t=-2.471, p<.05), '사고에 대한 피드백과 의사소통'(t=-3.356, p<.01)으로 나타났다. 간호사와 치위생사에게서 환자안전문화에 영향을 미치는 요인으로는 연령과 경력 주당 근무시간이었다. 결론 : 간호사와 치위생사의 환자안전문화 인식수준은 중간정도 수준으로, 환자안전문화 인식수준에 영향을 미치는 연령, 경력, 주당 근무시간 등이 고려된 접근과 적절한 근무시간 정착이 필요할 것으로 사료된다.

• 기본간호학회지
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• 제2권2호
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• pp.115-130
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• 1995

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. - Results are fellow : 1. A total of 116 of the nurses returned the questionaire 2. According to 88.2% of the respondents, the policy with regard to oral-hygine is determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occured. 3. In only 34.5% of case was a penight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complications observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms 0.9% normal saline gargling (47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate thatoral care in cancer patients undergoing chemothrapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.

• 한국산학기술학회논문지
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• 제22권1호
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• pp.445-453
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• 2021

본 연구는 암환자의 삶의 질에 영향을 미치는 요인을 인구사회학적 특성, 심신건강, 구강건강 측면에서 분석하고 암환자의 삶의 질 증진을 위한 기초자료를 제공하고자 시행되었다. 자료 수집은 국민건강영양조사 제7기 3차 년도 조사대상 중 암환자로 진단받은 235명을 최종대상자로 선정하였고 PASW Statistics ver 18.0 프로그램으로 복합표본 분석을 하였다. 연구결과 암환자 중 스트레스는 74.5%, 우울증은 84.3%, 활동제한은 15.3%가 경험하고 있었고 씹는 문제는 29.0%, 발음 문제는 13.6%가 경험하고 있었다. 구강건강에서 씹기 문제는 소득이 낮고(3.35±.21), 활동제한이 있는 경우(2.71±.31), 우울증이 있는 경우(3.01±.27) 높게 경험하고 있었다(p<0.05). 삶의 질에 영향을 미치는 요인은 소득이 낮은 경우 3.43배, 활동제한이 있는 경우 8.39배, 스트레스가 있는 경우 2.74배, 우울증이 있는 경우 4.58배, 씹기 문제가 있는 경우 2.68배, 말하기 문제가 있는 경우 4.92배 유의하게 높게 나타났다(p<0.05). 본 연구결과를 통해 암환자의 삶의 질 증진을 위해서는 심신 건강관리뿐만 아니라 구강 관리가 요구되었고, 암 치료 과정 중 합병증으로 발생하는 심신 및 구강 불건강 예방을 위해 암 치료과정에서 의료진의 통합적인 관리방안이 요구되었다.

• 대한간호학회지
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• 제25권4호
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• pp.653-667
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• 1995

Post - operative wound infections have been a serious problem in nursing care in the operating room and appear to be strongly related to the infection occurring during the performance of operation. The purpose of this study is to identify patterns in duration of surgical hand scrub (SHS), to evaluate the method of SHS and to examine the rate of glove perforation. Subjects for this study include 244 doctors and 169 nurses working in the operative theatre of a hospital in Seoul area. Test samples and related data were collected from this medical facility between April 1, through 15, and July 1, through 5, 1995 by the author and a staff member working in the operating room. For the study, data on the SHS of doctors and nurses were obtained at the time of operation and multiple batches of surgical gloves worn by the operating doctors were collected after each operation. The duration of SHS was measured with a stop watch and the method of SHS was evaluated according to Scoring Hand Scrub Criteria (SHS Criteria) and expressed as SHS scores. For the analysis of the data, t-test was used to compare the differences in the duration and the SHS scores of doctors and nurses, and Pearson's correlation coefficient was used to examine the relationship between the SHS duration and the SHS scores. The results of the study are summarized as follows. 1) The mean time spent in each SHS was 167 seconds in nurses, and 127 seconds in doctors. The data comparing nurses and doctors indicated that there were significant differences in Our ation of SH S between these two groups (t=5.58, p=.000). 2) The mean time spent in the first SHS was 145 seconds and that in the End SHS, 135 seconds, and there was not a significant difference in the duration of the SHS between doctors and nurses (t=1.44, P=.156). 3) The mean time spent in the SHS by OS (Orthopaedic surgery) doctors was 162 seconds, 150 seconds by NS(Neurologic surgery), 121 seconds by GS(General surgery), 94 seconds by OPH(Opthalmology) and DS(Dental surgery), 82 seconds by URO(Urology), 78 seconds by PS(Plastic surgery) and 40 seconds by ENT(Ear, Nose & Throat) These also showed a significant difference in the duration of the SHS among the medical specialities (t=4.8, P=.0001). 4) The average SHS score of the nurses was 15.2, while that of doctors was 13.1. The statistical analysis showed that t-value was 3.66, p was. 000. This indicates that the nurses actually clean their hands more thoroughly than the doctors do. 5) The average SHS score of NS doctors was 15.5, 15.3 for doctors for OPH,14.3 for OS,12.7 for GS, 12.0 for DS, 11.7 for URO, 10.1 for PS, 7.5 for ENT. Comparison of the average SHS scores from 8 specialties showed that there was a significant differences in the patterns of the SHS (F=5.08, P=.000) among medical specialties. 6) It appears that the operating personnel scrub the palms and dorsum of their hand relatively well, however, less thorough the nails and fingers. 7) The more the operating personnel spend their time in hand scrubbing, the more correctly they clean their hands(r=.6427, P<.001). 8) The overall frequencies of perforation in all post-operative gloves tested was 38 out of 389 gloves (10.3%). The perforation rate for PS was 13%, 12.1% for GS,8.8% for 05, and 3.3% for NS.

• 한국임상보건과학회지
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• 제5권1호
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• pp.825-833
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• 2017

Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.