• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.54-62
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• 2018

In the 2000's, due to a change in hospital management strategy, the organizational structure shifted from a hierarchical system to a team system. While the hierarchical system is characterized by being activity centered, job title linked, and vertically managed, the team system is characterized by being competency centered, job title segregated, and horizontally managed. The job titles of medical technologist manager was surveyed three times in 1997, 2007, and 2017. It has been confirmed through staff members working at 24 hospitals in more than 500 beds in the metropolitan area. The results of job titles follow are as follow: "Team Leader; Part Leader" 14/24 (59%), "Chief Technologist; Area Head Technologist" 7/24 (29%), and "Chief" 3/24 (12%). The present authors propose an alternative name based on the team system to refine the three job titles currently used by medical technologists. First, the Chief Technologist is unclear if it refers to the Technologist General Manager or Technologist Manager. The Chief Technologist should be changed to "Team Leader". Second, given that Area Head Technologist or Section Chief are on the same position as Head Nurse, we suggest that Area Head Technologist or Section Chief should be changed to "Part Leader". Third, while the organization regulation is marked merely as Department of Laboratory Medicine according to the hierarchical system, it is marked as Laboratory Medicine Team according to the team system. Medical technologists come to have more belongingness, feeling of solidarity, and intimacy under the team system.

• Clinical and Experimental Pediatrics
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• v.58 no.12
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• pp.491-500
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• 2015

Purpose: To investigate the caustic ingestion in children among different continents according to demographic characteristics (core purpose), main symptoms, common caustic agents, signs and symptoms, management, treatment and complications. Methods: This systematic review was performed by searching the databases Science Direct, ProQuest, Google Scholar, and PubMed, electronically and manually. We included studies that were published from 1980 to 2013, at University of Medical Sciences of Tabriz, Iran. A strategic search was performed with keywords including caustic, corrosive, ingestion and children, and was limited to articles in English and Persian. Statistical analysis was performed by SPSS ver. 18. Results: Of 63 selected articles of caustic ingestion with 9,888 samples, the proportion of Africa was 3 articles (4.8%) and 95 samples (1%), America 9 articles (14.3%) and 305 sample (3%), Asia 29 articles (46%) and 2,780 samples (28.1%), Europe 17 articles (27%) and 3,002 samples (30.4%), and Oceania 5 articles (7.9%) and 3,706 samples (37.5%). The average age was in the Africa $3.07{\pm}2.02years$, America $3.17{\pm}1.83years$, Asia $3.34{\pm}1.58years$, Europe $3.58{\pm}2.09years$ and Oceania $3.52{\pm}2.02years$. Sex distribution was in Africa 76 males (0.91%) and 19 females (0.23%), America 49 males (0.58%) and 41 females (0.49%), Asia 1,575 males (18.76%) and 1,087 females (12.95%), Europe 1,018 males (12.13%) and 823 females (9.8%), and Oceania 1,918 males (22.85%) and 1,788 females (21.3%). Statistical analysis of the data indicated higher consumption in Europe and Oceania in the boys with higher average age of years. Conclusion: The comparison of caustic ingestion indicated that the cause substances of caustic ingestion in children are different among continents, therefore prevention strategy and different treatment guidelines among continents will be needed.

• Clinical and Experimental Pediatrics
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• v.61 no.7
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• pp.210-216
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• 2018

Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1-98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2-31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.523-531
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• 2020

The aim of this study was to determine the mediating effects in the relationships among nursing organizational culture, workplace bullying, and job stress of nurses. For the descriptive correlational study design, data were collected using a structured questionnaire from nurses at university hospitals (N=130). Statistical analysis was performed on the collected data using SPSS 22.0 statistics program. The mean scores of nurses for nursing organizational culture, workplace bullying, and job stress were 2.99±0.74, 1.85±0.65, and 2.50±0.35, respectively. Nursing organizational culture of nurses had a negative correlation with both workplace bullying (r=-0.45, p=0.001) and job stress (r=-0.61, p=0.001), whereas workplace bullying showed a positive correlation with job stress (r=0.42, p=0.001). Sobel test was conducted to verify the mediating effects, and nursing organizational culture was statistically significant as a partial mediating effect of 0.13 (sobel'z=-2.287, p<0.05) on the effect of workplace bullying of nurses on job stress. These results indicate that nursing organizational cultures need to be established to reduce workplace bullying. It is important to create a nursing work environment that can reduce job stress, a better understanding of the nursing organization cultures related to nursing tasks is crucial, and it is necessary to develop an institutional education strategy for prevention education in hospital organizations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.4
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• pp.707-716
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• 2009

The levels of psychosocial stresses and fatigue of firemen were analyzed to reveal the various factors related to them. The self-administered questionnaires were performed to 262 firemen ill Cheonsju City. In terms of various levels of psychosocial stresses, 12.2% were under potential stresses, 87.8% were under high-level of stress, but healthy group was not found. The levels of fatigue symptoms divided by the median of total scores was 51.1% of low levels, and 48.9% of high levels. Multiple stepwise analysis revealed that the factors or influence on psychosocial stresses with explanatory powers of 11.5% included subjective health status, job satisfaction, job demand and alcohol drinking habits. The factors of influence on fatigue symptoms with explanatory powers of 9.0% included subjective health and regular exercises. The study results indicate that the level of stress or fatigue is so complicatedly influenced by variable factors. Thus the effective strategy for stress and fatigue reduction among firemen should include additional programs focusing on health promotion.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.226-232
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• 1999

Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.120-128
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• 2017

Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.590-597
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• 2020

Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.389-399
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• 2016

The purpose of this study was to provide the evidence necessary to establish job stress management strategies to improve office workers conditions by looking at the impact on job stress factors depending on the nature of the organization. The stress related variables (job stress and psychological well-being) and organizational effectiveness variables (job satisfaction, job engagement, intention to leave, and presentieesm) was included. A total of 154 questionnaires were distributed from 26th June to 1 August 2014 and 150 people were analyzed. The results indicated that a lack of reward was negatively correlated with job satisfaction and job engagement, and positively correlated with the intention to leave (p<0.05) in a large-sized company model. Moreover, in a medium-sized company model, organizational injustice was statistically significant with job satisfaction and job engagement. Organizational injustice, lack of reward, and occupational climate was positively correlated with the intention to leave (p<0.05). This study has its significance in that it looked at the job stress as a predictive variable to explain the organizational effectiveness and highlights the need to establish a stress management strategy depending on the nature of the company.