• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.207-216
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• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.717-722
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• 2016

In this paper, in order to support the peak current limiting function depending on the intensity of the fault current at the early stage of failure, a two magnetically coupled type superconducting fault current limiter (SFCL) is proposed, which includes high-Tc superconducting (HTSC) element 1, where the existing primary and secondary coils are connected to one iron core in parallel, and HTSC element 2, which is connected to the tertiary winding using an additional iron core. The results of the experiments in this study confirmed that the two magnetic coupling type SFCL having coil 1 and coil 2 connected in parallel using dual iron cores is capable of having only HTSC element 1 support the burden of the peak current when a failure occurs. The reason for this is that although HTSC element 1 was quenched and malfunctioned because the instantaneous factor of the initial fault current was large, the current flowing to coil 3 did not exceed the critical current, which would otherwise cause HTSC element 2 to be quenched and not function. In order to limit the peak current upon fault through the sequential HTSC elements, the design should allow it to have the same value as the low value of coil 1 while having coil 3 possess a higher self-inductance value than coil 2. In addition, a short-circuit simulation experiment was conducted to examine and validate the current limiting and recovery characteristics of the SFCL when the winding ratio between coil 1 and coil 2 was 0.25. Through the analysis of the short-circuit tests, the current limiting and recovery characteristics in the case of the additive polarity winding was confirmed to be superior to that of the subtractive polarity winding.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.189-196
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• 2018

Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.26-36
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• 2021

Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥²-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.7-18
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• 2021

Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.

• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.315-322
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• 2018

Purpose: To analyze the clinical and angiographic features with outcome of transcatheter arterial embolization in patients with secondary postpartum hemorrhage. Materials and Methods: Clinical details and angiographic features with assessment of arterial embolization were reviewed in total 38 patients underwent arterial embolization at single tertiary referral center. Results: Twenty patients (53%) had Cesarean section. The major causes of bleeding were iatrogenic vascular injury, and retained placenta (55%). The patterns of vaginal bleeding were recorded as intermittent (50%), or as persistent (50%). Seven patients (18%) were hemodynamically unstable at presentation. Positive angiographic findings appeared in eighteen patients (47.3%). The frequency of pseudoaneurysm was statistically high in the Cesarean section (p < 0.001). The used embolic agents except gelfoam were N-butyl cyanoacrylate (n = 7), and microcoil (n = 7). Unilateral selective embolization (26.3%) was shown effective in superselective embolization of bleeding focus. Technical and clinical success rate were 100% and 97.4%, respectively with no complication. Sixteen resumed regular menstruation, and one pregnancy were observed in patients with available follow-up of over 6 months. Conclusion: Considerable rate of hemodynamically unstable patients was observed with high rate of positive angiography findings. Given high successful rate and few complications, early angiographic assessment with embolization should be considered.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.8-16
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• 2021

Purpose: This study was conducted to analyze the social factors influencing the 'authenticity of suicidal ideation' based post-suicidal care programs in emergency departments (EDs). Methods: This retrospective study was an analysis using the data of patients who had attempted suicide and visited the ED in tertiary urban hospitals from January 1, 2016, to December 31, 2018. The variables examined included gender, age, history of previous psychiatric disease, suicide method, and the number of previous attempts. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the registration rate for the community-based post-suicide care program. Results: Overall,1,460 suicides were analyzed, 177 (1.16%) showed a high authenticity of suicide. The social factors influencing the authenticity of suicide intent were the unmarried status of men and women, joblessness, history of mental illnesses, more than two previous suicide attempts, the influence of alcohol, and an attempt to commit suicide after midnight more specifically between 24:00 to 6:00 hours in the morning (p<.05). The factors influencing the severity of the condition of high authenticity suicide patients were low Glasgow coma scores (12 points or less), lactate levels, and oxygen saturation observed in the patients who were admitted to the intensive care unit for treatment and died (p<.05). Conclusion: The need for evidence-based preventive measures and early assessment tools at the emergency medicine level is emphasized to reduce the rate of suicide attempts. If the results of this study are used in the management of suicide prevention, the evaluation of the authenticity of suicide intent will be more likely to be made at the emergency medicine level, allowing the severity to be assessed earlier.

• Journal of Korea Entertainment Industry Association
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• v.14 no.4
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• pp.371-380
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• 2020

This study was conducted to investigate the effects of depression on fear of stroke recurrence and health-related quality of life in Young Adults with Stroke. The subjects of this study were 240 young stroke patients who visited the outpatient department of neurology at a tertiary hospital in C province and J university hospital from July 24, 2018, to November 22, 2018. The collected data were analyzed for statistical significance and hypothesis verification using SPSS 24.0 and SmartPLS 3.0. The results showed that guilt and mental depression in depression factors had an effect on fear of stroke recurrence, and mental depression had a statistically significant impact on health-related quality of life. Also, fear of recurrence has a significant impact on health-related quality of life. The results of this study suggest that overcoming fear of stroke recurrence by interventions that reduce guilt and mental depression through early assessment of their depression, thus it can significantly contribute to improving health-related quality of life in young adults with stroke.

• Journal of Korean Clinical Nursing Research
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• v.29 no.2
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• pp.198-209
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• 2023

Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1298-1311
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• 2022

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.