• Korean Medical Education Review
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• v.25 no.1
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• pp.45-54
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• 2023

We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors' positions.

• Journal of Biomedical Engineering Research
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• v.45 no.2
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• pp.90-94
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• 2024

Diagnosing wounds presents a significant challenge in clinical settings due to its complexity and the subjective assessments by clinicians. Wound deep learning algorithms quantitatively assess wounds, overcoming these challenges. However, a limitation in existing research is reliance on specific datasets. To address this limitation, we created a comprehensive dataset by combining open dataset with self-produced dataset to enhance clinical applicability. In the annotation process, machine learning based on Gradient Vector Flow (GVF) was utilized to improve objectivity and efficiency over time. Furthermore, the deep learning model was equipped U-net with residual blocks. Significant improvements were observed using the input dataset with images cropped to contain only the wound region of interest (ROI), as opposed to original sized dataset. As a result, the Dice score remarkably increased from 0.80 using the original dataset to 0.89 using the wound ROI crop dataset. This study highlights the need for diverse research using comprehensive datasets. In future study, we aim to further enhance and diversify our dataset to encompass different environments and ethnicities.

• Speech Sciences
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• v.5 no.1
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• pp.121-139
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• 1999

Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.141-147
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• 2011

The aim of this study was to evaluate histomorphometrically and compare the efficiency of various bone graft material and autogenous tooth bone graft material which were used in sinus bone graft procedure. Subjects were the 24 patients who had treated with sinus bone graft using lateral approach from October 2007 to September 2009 at SNUBH. The average age was $52.51{\pm}11.86$ years. All cases was taken after 4month of procedure and divided into 3 groups according to bone graft material. Group 1: autogenous tooth bone graft material, Group 2: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), group 3: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). Total 37 implant placement area were included and evaluated(7 in group 1, 10 in group 2, 20 in group 3). Evaluation of new bone formation, ratio of woven bone to lamellar bone, ratio of new bone to graft material were performed on each tissue section. Kruskal-Wallis test was used for statistical analysis(SPSS Ver. 12.0, USA). New bone formation were $52.5{\pm}10.7%$ in group 1, $52.0{\pm}23.4%$ in group 2, $51.0{\pm}18.3%$ in group 3. There were no statistical significant differences between each groups. Ratio of woven bone to lamella bone were $82.8{\pm}15.3%$ in group 1, $36.7{\pm}59.3%$ in group 2, $31.0{\pm} 51.2%$ in group 3. Ratio of new bone to graft material were $81.3{\pm}10.4%$ in group 1, $72.5{\pm}28.8%$ in group 2, $80.3{\pm}24.0%$ in group 3. After 4 month of healing period, all group showed favorable new bone formation and around graft material and implant. Within limitation of our study, it is suggested that autogenous tooth bone graft material might be used as novel bone graft material for sinus bone graft.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.705-717
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• 1998

Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical educational materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and reasonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analysis of education guide, on ostomate included 14 subcategories : introduction, structure and function of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defecation management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostomates to understand their physical structure changes with specific explanations on gastrointestinal tracts with figures. 4. Six institutions did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations on natural defecation are needed. The benefits and pitfalls of natural defecation should be more specified. 7 No psychosocial difficulties of ostomy management were addressed. 8. The efficiency of enema can be better understood through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgrey. 11. Most institutions explained subcategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations on normal structure and function of urinary tracts, types of ureterostomy, how to manage skin, usage and types of instrument, commercial urostomy, how to manage instrument, daily life, introduced the general contents. However, more specific explanations were needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.446-456
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• 2005

Nerve growth factor(NGF) has a critical role in peripheral nerve regeneration. The aim of this study is to construct a well-functioning hNGF-$\beta$ recombinat adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with adenovirus mediated hNGF-$\beta$ gene transfection into Schwann cells. First PCR associated cloning of GFP-tagged hNGF-$\beta$ which was ligated into E1/E3 deleted adenoviral vector was performed and tranfected into E. coli to construct hNGF-$\beta$ recombinant adenovirus. After production of recombinat adenovirus in a large scale, its transfection efficiency, expression, and function were evaluated using cell lines or primarily cultured cells of HEK293 cells, Schwann cells, fibroblast(NIH3T3) and myocyte(CRH cells). GFP expression was observed in 90% of infected cells compared to uninfected cells. Total mRNA isolated from hNGF-$\beta$ recombinat adenoviru infected cells showed strong RT-PCR band, however, LacZ recombinant adenovirus infected or uninfected cells did not. NGF quantification by ELISA showed a maximal release of 18.865 +/- 0.31ng/mL at 4th day. PC-12 cells exposed to media with hNGF-$\beta$ recombinant adenovirus infected Schwann cell demonstrated higher levels of differentiation compared with controls. We generated hNGF-$\beta$ recombinant adenovirus and induced over expression of NGF successfully in nonneuronal and neuronal cells. Following these result, it is expected to develop an improved treatment strategy peripheral nerve regeneration using the hNGF-$\beta$ gene transfected cells.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.96-108
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• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.574-581
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• 2018

Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.72-89
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• 2000

Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two- hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.