• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.20-30
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• 2020

Tuberculosis (TB) remains a threat to public health and is the leading cause of death globally. Isoniazid (INH) is an important first-line agent for the treatment of TB considering its early bactericidal activity. Resistance to INH is now the most common type of resistance. Resistance to INH reduces the probability of treatment success and increases the risk of acquiring resistance to other first-line drugs such as rifampicin (RIF), thereby increasing the risk of multidrug-resistant-TB. Studies in the 1970s and 1980s showed high success rates for INH-resistant TB cases receiving regimens comprised of first-line drugs. However, recent data have indicated that INH-resistant TB patients treated with only firs-tline drugs have poor outcomes. Fortunately, based on recent systematic meta-analyses, the World Health Organization published consolidated guidelines on drug-resistant TB in 2019. Their key recommendations are treatment with RIF-ethambutol (EMB)-pyrazinamide (PZA)-levofloxacin (LFX) for 6 months and no addition of injectable agents to the treatment regimen. The guidelines also emphasize the importance of excluding resistance to RIF before starting RIF-EMB-PZA-LFX regimen. Additionally, when the diagnosis of INH-resistant TB is confirmed long after starting the first-line TB treatment, the clinician must decide whether to start a 6-month course of RIF-EMB-PZA-LFX based on the patient's condition. However, these recommendations are based on observational studies, not randomized controlled trials, and are thus conditional and based on low certainty of the effect estimates. Therefore, further work is needed to optimize the treatment of INH-resistant TB.

• Research in Community and Public Health Nursing
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• v.11 no.1
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• pp.222-230
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• 2000

Complementary & Alternative Medicine(CAM) have become increasingly popular with health care consumer in recent years. The nurse's attitude and beliefs about CAM will influence the response. to the patient's demands and inquiries. The purpose of this study is to evaluate the attitude and beliefs of nurses about CAM. The study was performed in 600 nurses from October to December in 1999 : Nurses were working one university hospital & one general hospital were located in TaeGu city. and two general hospitals located in Kyung Buk city. The study used specially designed questionnaire to 600 nurses, and analyzed by using descriptive statistics, ANOVA data based on 460 completed questionnaire. The findings of the study are as following. 1. The credible forms of subject about CAM were ranked acupunture (66.1%). herbal medicine(56.5%), Sooji chim (50.4%) et al. 2. In the credibility of subject about CAM there were not significant difference by age. clinical career, marriage, health status. The most reason of positive credibility was 'Being human perspective and spiritual supporting'. While the most reason of negative credibility was 'the lack of science test and doubt of disease treatment'. 3. In the experienced rate of subject about CAM there were significant difference not by health status but by age($x^2$=10.096, p= .006), clinical career($x^2$=7.648 p= .022), marriage($x^2$=9.317. p= .002). In the satistied rate of subject about CAM there were not significant difference by age, clinical career, marriage, health status 4. The most usable forms of subject about CAM in nurse's practice was Music therapy(55.9%), and ranked massage (50.9%), acupressure(32.8%). Sooji chim (27.8%) et al.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.109-122
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• 2013

Objectives : To research the needed Buddhistic ethical beliefs and psychotherapy from representative medical records of oriental medicine. Methods : The baseline data this research used is Myeong-Ui-Lyu-An, Sok-Myeong-Ui-Lyu-An, Ui-Bu-Jeol-Lok and from the variety of medical records; we extracted 22 medical records that refer to Buddhist thoughts. The sequence of medical records is determined by analyzing the contents of all medical records and grouping them by their categories. Results : The representative ethical mind that a doctor needs is the 'mercy thought' from Buddhism. This way, the doctor has 'pity' on patients and expects no reward for what he had done. 'Spells and religious beliefs developed into medical treatment procedures by Buddhism and oriental medicine psychotherapy. Using the belief that everything is made of the mind, which is the point of the 'Hwa-Eum' theory and the realization that the psychotic factors have a big role in the occurrence and progress of sicknesses, we emphasized supportive psychotherapy or more specifically, the suggestive therapy. 'Anguish' is an important point in the occurrence and progress of illnesses. To solve this, we used 'Zen family's 'Zen self-discipline' and ascetic life from Buddhism. According to Buddhism, a human's metal conflict and love or malingering from obsession is the cause of all mind illnesses. To heal these, a doctor must have an insight of the patient's mind more than the symptoms. Conclusions : Buddhistic thoughts suggested clearly the mentality necessary for oriental medical psychotherapist and medical ethics for a doctor.

• Journal of Trauma and Injury
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• v.29 no.3
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• pp.68-75
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• 2016

Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.3
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• pp.46-63
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• 2017

Objectives The Korean Medicine (KM) PHR platform is a personalized healthcare service which allows individuals to keep and manage their own health records. When parents are reporting for their children from their memories, there is high possibility of recall errors. In these cases, it could be useful for doctors to collect the patient's symptoms through PHR platform. In this study, we aimed to investigate the clinical significance of the PHR by using the KM PHR platform in the pediatric clinic. Methods The PHR platform was used to collect child health information from parents and child care teachers. The collected data were analyzed in comparison with the results of screening by pediatrician. Results A total of 58 children were recruited, 44 of which health information were collected from their parents and their child care teachers. The remaining 14 children's health information were collected from their parents only. As a result the parents tended to perceive their children weaker than the child care teacher. Compared to other organs, there was a only significant difference in the heart weakness score and spleen weakness score in the comparison of the weak and healthy children. Conclusions Although the study was conducted on a small group of subjects, and used PHR platform developed specifically for adults to indirectly input child's symptoms, and analyzed their health information, there was a difference in health records between information providers. Development of PHR platform for children is needed to collect more reliable information.

• Journal of Biomedical Engineering Research
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• v.27 no.6
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• pp.392-401
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• 2006

Image Guided Surgery (IGS) system which has variously tried in medical engineering fields is able to give a surgeon objective information of operation process like decision making and surgical planning. This information is displayed through 3D images which are acquired from image modalities like CT and MRI for pre-operation. The technique of image registration is necessary to construct IGS system. Image registration means that 3D model and the object operated by a surgeon are matched on the common frame. Major techniques of registration in IGS system have been used by recognizing fiducial markers placed on the object. However, this method has been criticized due to additional trauma, its invasive protocol inserting fiducial markers in patient's bone and generating noise data when 2D slice images are acquired by image modality because many markers are made of metal. Therefore, this paper developed shape-based registration technique to improve the limitation of fiducial marker based IGS system. Iterative Closest Points (ICP) algorithm was used to match corresponding points and quaternion based rotation and translation transformation using closed form solution applied to find the optimized cost function of transformation. we assumed that this algorithm were used in Total Knee replacement (TKR) operation. Accordingly, we have developed region-based 3D registration technique based on anatomical landmarks and this registration algorithm was evaluated in a femur model. It was found that region-based algorithm can improve the accuracy in 3D registration.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.151-160
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• 2010

Purpose: The purpose of this study was to evaluate the effects of teaching method using Standardized Patients (SPs) on nursing competence, self-directed learning readiness, and problem solving ability-focusing on subcutaneous insulin injection. Methods: This research was a nonequivalent control group non-synchronized post-test design. The subjects consisted of 62 junior nursing students at E University. Scenarios to train SPs and checklists to evaluate the students' competence were developed by our research team. The experimental group (n=31) participated in the teaching class using SPs. The control group (n=31) received traditional practice education. The collected data were analyzed with descriptive analysis, $\chi^2$/Fisher's exact test, t-test, Pearson's correlation coefficient, and Cronbach's $\alpha$ using SPSS WIN 14.0 Program. Results: The mean scores of competence, self-directed learning readiness, and problem solving were significantly higher in the experimental group than the control group. Conclusion: As confirmed by this research findings, the teaching method using SPs was more effective than the traditional method to improve junior nursing students' competence, self-directed learning readiness, and problem solving. Therefore, It is necessary to develop a various of scenarios and to testify their effectiveness.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2011.05a
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• pp.77-80
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• 2011

Medical robot has four fields. Surgery assistant robot, robotic surgery, Surgery Simulator, rehabilitation robot. Thus, medical robots is often high precision and reliability requirements for operations are being developed. Medical service robot's another sector is care for service robots. Care services robot is the hospital's reception work and biometric data acquisition of patients, the hospital in location and content information provide to patients. But now medical service robot practical acceptance process failed to progress. In this paper were the medical service robot systems design and implementation. Implemented the robot system is using the standard protocols for the exchange of medical information and can be linked with hospital information system. The hospital's patient reception and processing, to provide care waiting number information.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.38-43
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• 2009

With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.