• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권3호
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• pp.17-26
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• 2020

Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

• 한국의료질향상학회지
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• 제19권1호
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• pp.30-42
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• 2013

Objectives: This study was intended to check if the "Creating Clean Wards" project, which is an innovative reinforced campaign activity targeting infection control strategies and active surveillance cultures for VRE (vancomycin resistant enterococci) high-risk patients to be admitted in the NS (neuro-surgery) wards, would be reduced the incidence rates of VRE acquisition, transmission rates. Methods: 75 subjects of the VRE high-risk patients were surveyed by carrying out active surveillance cultures of VRE colonization 11 times from January to March, 2012. And the retrospective study was conducted dividing them into two groups. Results: The incidence rates of VRE acquisition was reduced to 3.67 cases per 1,000 patients day in the control group and to 2.88 cases in experimental group, which was not statistically significant (p = .753). VRE transmission rates of 0.0015 per day before the project tended to increase to 0.0019, although not statistically significant (p = .650). As a result of multivariate analysis with regard to using glycopeptide antibiotics in order to find out risk factors of VRE colonization, the patients who had been treated with glycopeptide until VRE colonization showed 274.41 times higher rate. Conclusion : For effective VRE infection control in NS wards, We should carry out active surveillance culture regularly, especially patient of using glycopeptide. And block the spread of VRE by strengthening infection control through the strict isolation and the changed mind-set of members motivated by the "Creating Clean Wards" campaign.

• Parasites, Hosts and Diseases
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• 제40권1호
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• pp.17-24
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• 2002

We have cloned a cDNA encoding a cysteine proteinase of the Acanthamoeba healui OC-3A strain isolated from the brain of a granulomatous amoebic encephalitis patient. A DNA probe for an A. healui cDNA library screening was amplified by PCR using degenerate oligonucleotide primers designed on the basis of conserved amino acids franking the active sites of cysteine and asparagine residues that are conserved in the eukaryotic cysteine proteinases. Cysteine proteinase gene of A. healui (AhCPI) was composed of 330 amino acids with signal sequence, a proposed pro-domain and a predicted active site made up of the catalytic residues, $Cys^{25},{\;}His^{159},{\;}and{\;}Asn^{175}$. Deduced amino acid sequence analysis indicates that AhCPI belong to ERFNIN subfamily of C 1 peptidases. By Northern blot analysis. no direct correlation was observed between AhCPI mRNA expression and virulence of Acanthamoeba, but the gene was expressed at higher level in amoebae isolated from soil than amoeba from clinical samples. These findings raise the possibility that AhCPI protein may play a role in protein metabolism and digestion of phagocytosed bacteria or host tissue debris rather than in invasion of amoebae into host tissue.

• 지역사회간호학회지
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• 제15권1호
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.185-196
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• 2017

본 연구의 목적은 메르스 환자 간호에 대한 간호사의 실제적인 경험을 파악하기 위함이다. 본 연구에 참여한 대상자는 S시 1개 상급종합병원에서 메르스 환자 간호에 참여한 간호사 9명이며, 자료 수집을 위해 심층 면담이 수행되었다. 자료수집 기간은 2015년 8월부터 2016년 3월까지였다. 수집된 자료는 Colaizzi의 현상학적 방법에 따라 절차에 맞게 분석하였다. 도출된 5개의 범주는 다음과 같다. '1. 신종 감염병 전염 위험성에 따른 불안과 부담', '2. 메르스 환자 간호사라는 이유로 느끼는 사회적 고립', '3. 준비되지 않은 치료환경 문제에 부딪힘', '4. 힘겨운 메르스 환자 간호과정을 이겨냄', '5. 신종 감염병 대책 마련에 대해 성찰함'이었다. 이와 같은 결과는 메르스 환자를 포함한 다양한 감염병 환자를 담당하는 간호사의 부정적 영향 뿐 아니라, 긍정적인 경험을 도출했다는데 의의가 있다. 이를 바탕으로 심리사회적 부정적 영향을 감소시키고, 긍정적인 적응을 향상시키는데 근거로 활용될 수 있을 것이며, 간호사를 포함한 보건의료 종사자가 신종 감염병 환자를 간호하기 위한 인력, 부서 및 실무지침 마련이 필요하다고 생각된다.

• 한국임상수의학회지
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• 제28권2호
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• pp.254-257
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• 2011

2년령 bearded dragon이 활력 감소 및 식욕 부진으로 충북대학교 동물의료센터에 내원하였다. 분변 검사 결과 다수의 세균과 함께 효모의 증식이 관찰되어 장염으로 진단되었다. 진균 배양 및 분자생물학적 진균 동정 결과 증식된 효모는 Pichia (P.) burtonii로 확인되었다. 치료는 ketoconazole과 trimethoprim/sulfamethoxazole을 3일간 경구 투여하였다. 치료 3일 후 분변 내 효모는 사라졌으며, 이후 환자는 회복되었다. 본 증례와 사람에서의 보고를 종합하면 P. burtonii 는 장염이 있는 bearded dragon의 기회성 병원체로 추정된다. 또한 본 증례는 bearded dragon에서의 P. burtonill의 과증식에 대한 최초의 보고이다.

• Restorative Dentistry and Endodontics
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• 제34권1호
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• pp.38-41
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• 2009

복합레진 수복을 위해 상아질에 total-etch adhesive system을 적용할 경우, 37% 인산 산부식제가 널리 사용되고 있다. 37% 인산은 매우 강력한 부식제로 구강점막이나 안면피부와 접촉되었을 때 심각한 해로운 효과가 발생될 수 있다. 이 증례 보고에서는 복합레진 수복과정에서 사용된 인산 산부식제에 의해 안면피부에 발생된 의원성 화학적 화상을 보고하고자 한다. 산부식제에 의한 화학적 화상은 산부식제를 부주의하고 부적절하게 사용함으로 발생될 수 있으며, 이러한 의원성 손상을 방지하기 위해서는 산부식과 수세과정 후 산부식제가 완전히 제거되었는지를 확인하여야하며, 복합레진 수복 시 러버댐이나 적절한 격리 기구를 사용하는 것이 필요할 것이다. 화상이 발생하였다면, 적절한 응급처치 후 피부과로 의뢰하는 것이 필요할 것이다.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.258-262
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• 2013

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

• Interdisciplinary Bio Central
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• 제4권3호
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• pp.6.1-6.12
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• 2012

Parkinson's disease (PD) is a complicated neurodegenerative disorder although it is oftentimes defined by clinical motor symptoms originated from age dependent and progressive loss of dopaminergic neurons in the midbrain. The pathogenesis of PD involves dopaminergic and nondopaminergic neurons in many brain regions and the molecular mechanisms underlying the death of different cell types still remain to be elucidated. There are indications that PD causing disease processes occur in a global scale ranging from DNA to RNA, and proteins. Several PD-associated genes have been reported to play diverse roles in controlling cellular functions in different levels, such as chromatin structure, transcription, processing of mRNA, translational modulation, and posttranslational modification of proteins. The advent of quantitative high throughput screening (HTS) tools makes it possible to monitor systemic changes in DNA, RNA and proteins in PD models. Combined with dopamine neuron isolation or derivation of dopamine neurons from PD patient specific induced pluripotent stem cells (PD iPSCs), HTS techonologies will provide opportunities to draw PD causing sequences of molecular events in pathologically relevant PD samples. Here I discuss previous studies that identified molecular functions in which PD genes are involved, especially those signaling pathways that can be efficiently studied using HTS methodologies. Brief descriptions of quantitative and systemic tools looking at DNA, RNA and proteins will be followed. Finally, I will emphasize the use and potential benefits of PD iPSCs-derived dopaminergic neurons to screen signaling pathways that are initiated by PD linked gene mutations and thus causative for dopaminergic neurodegneration in PD.

• 대한소아치과학회지
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• 제40권2호
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• pp.120-126
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• 2013

심한 우식을 보이는 미성숙 영구치 치료에 있어서 치수생활력을 보존하는 것은 중요하다. 치수절단술을 시행 시 생체적합성이 있는 재료를 이용하여 치료함으로써 남아있는 생활력이 있는 치수를 보호하며 미성숙 영구치의 치근 성장을 도모할 수 있다. 혈소판 농축 섬유소는 환자의 혈액을 직접 채취하여 적용하기 때문에 생체적합성이 뛰어나며 다양한 성장인자를 함유하고 있어 치수생활력을 유지하고 미성숙 영구치의 치근 발육을 촉진시킬 수 있다. 본 증례에서는 심한 치아 우식증을 보이는 미성숙 영구치에서 치수절단술 시행 후 남아 있는 치수 상부에 혈소판 농축 섬유소를 적용하였다. 정기적인 검진 결과 미성숙 영구치의 치근 성장 및 정상적인 치아 주위 조직들이 관찰되었다. 향후 장기간의 임상적 관찰이 필요할 것이며 더 많은 임상 증례를 바탕으로 한 연구가 필요할 것이다.