• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Journal of Korean Academy of Nursing
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• v.52 no.4
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• pp.378-390
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• 2022

Purpose: This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR). Methods: A pretest-posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge-attitude-practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest). Results: A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses' adverse event reporting were above the moderate level. Conclusion: The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture.

• Journal of Advanced Navigation Technology
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• v.27 no.1
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• pp.139-145
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• 2023

When a doctor examines a patient in a hospital, the doctor directly checks the patient's condition and conducts a face-to-face diagnosis through dialogue with the patient. However, it is often difficult for doctors to directly treat patients. Recently, several types of telemedicine systems have been developed. However, the systems have lack of capabilities to observe heart disease, neck condition, skin condition, inside ear condition, etc. To solve this problem, in this paper, an interactive telemedicine robot system with autonomous driving in a room capable of visual examination and auscultation of patients is developed. The developed robot can be controlled remotely through the WebRTC platform to move toward the patient and check a patient's condition under the doctor's observation using the multi-joint robot arm. The video information, audio information, patient's heart sound, and other data obtained remotely from patients can be transmitted to a doctor through the web RTC platform. The developed system can be applied to the various places where doctors are not possible to attend.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.187-191
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• 2006

Background: Patient-controlled epidural analgesia (PCEA), using a local anesthetic-opioid mixture, has been effectively applied after total knee replacement (TKR) surgery, which is associated with intense postoperative pain that requires postoperative analgesia for both rehabilitation and the pain itself. However, adverse opioid-related effects, such as nausea, vomiting and pruritus, are commonly encountered. It was our hypothesis that the adverse opioid-related effects could be reduced by the addition of naloxone, an opioid antagonist, to a mixture of fentanyl-ropivacaine PCEA. Methods: In 120 patients undergoing elective TKR surgery, epidural or combined spinal-epidural (CSE) anesthesia was performed and PCEA applied. In the control group (n = 65), 0.16% ropivacaine and $3{\mu}g/ml$ fentanyl ($2.4{\mu}g/ml$ for those older than 65 yrs) were administered. In the naloxone group (n = 55), naloxone ($2{\mu}g/ml$) was coadministered with the above regimen. The incidence and severity of postoperative nausea and vomiting, and the frequency of pruritus, the visual analog score (VAS) and the PCEA volume used were assessed 6 and 24 hrs after surgery. Results: The incidence of nausea and vomiting during the early postoperative period, and those of pruritus during the late postoperative period were significantly lower in the naloxone group. The VAS pain scores, the PCEA volume used and amount of rescue IV meperidine were similar in the two groups. Conclusions: A small dose of naloxone mixed with an opioid significantly reduces the incidence and severity of adverse opioid-related effects in PCEA, without reducing the analgesic effect.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.257-265
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• 1995

Patient-Controlled Analgesia (PCA) has been widely used for postoperative pain relief. Meperidine is useful for PCA and has efficient analgesia, rapid onset, and low incidence of adverse effect. To compare the analgesic effect, total dose and hourly dose, side effect and neonatal status of breast feeding with meperidine via intravenous or epidural PCA for 48 hours after Cesarean Section, 40 parturient women undergoing elective Cesarean Section were randomly divided into two groups. Each respective group of 20 parturient women received meperidine via one of the intravenous PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after epidural block with 2% lidocaine 20ml combined with general anesthesia with only $N_2O$ and $O_2$ (EpiPCA group) when they first complained of pain in recovery room. Following the administration of analgesic initial dose, parturient women of IVPCA group were allowed intravenous meperidine 10 mg every 8 minutes when they felt pain. The EpiPCA group received additional bolus dose of meperidine 2 mg and bupivacaine 0.7 mg were administered every 8 minutes as requested the patients with hourly continuous infusion of meperidine 4 mg and bupivacaine 1.4 mg. Data was collected during the 48 hours observation period including visual analog scale (VAS) pain scores, total meperidine dose, hourly dose during 48 hours and each time interval, incidence of adverse effect, satisfaction, and neonatal status with breast feeding. VAS pain scores of analgesic effect in EpiPCA group was significantly lower than in IVPCA group at 2 hours after the initial pain after Cesarean Section. Total dose and hourly dose of meperidine significantly reduced in EpiPCA group. Hourly dose of meperidine at each time interval significantly reduced during first 6 hours and from 12 hours to 24 hours in EpiPCA group. The side effects in IVPCA group were mainly sedation, nausea, and local irritation of skin. And EpiPCA group experienced numbness and itching. The degree of satisfaction of parturient women was 88.2 % in IVPCA group and 85.7 % in EpiPCA group. We did not observe any sedation, abnormal behavior, or seizure like activity in any neonates of breast feeding. From the above results we conclude that epidural PCA was more efficiently analgesic, less sedative, and consumptional, and safer for neonate than intravenous PCA, and could be an alternative method to intravenous PCA.

• Journal of Korean Medicine for Obesity Research
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• v.20 no.2
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• pp.178-192
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• 2020

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.12-17
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• 2012

Purpose : The patient's clothes and sheet after radioiodine therapy must be disposed of by related regulation. That must be disposed of as radioactive wastes, but that is reusing after radioactivity decay by keeping for the certain period of time. In general, The minimum storage period calculate by standard of take radioactive substance out of radiation controlled area based on measured surface contamination level. But the measurements of surface contamination level are able to differ by measurement method. In this paper, I wish to calculate the minimum storage period of patient's clothes and sheet after radioiodine therapy by measure nuclide concentration offered by the regulation on self-disposal of radioactive wastes. Materials and Methods : The whole area of patient's clothes and sheet measured 31 patients(male:9 patients, female:22 patients), who had radioiodine therapy(3.7 GBq:13 patients, 5.55 GBq:16 patients, 7.4 GBq:2 patients) from july 2011 to march 2012. The minimum storage period is calculated by the regulation on self-disposal of radioactive waste(100 Bq/g) and standard of take radioactive substance out of radiation controlled area(4 kBq/m2) Results : The minimum storage period of pillow sheet, upper uniform, lower uniform by standard of take radioactive substance out of radiation controlled area were each 4.6 days, 63days, 78 days. The minimum storage period of pillow sheet, upper uniform, lower uniform by the regulation on self-disposal of radioactive waste were each 18.1 days, 43 days, 62 days. Conclusion : We can verify that patient's clothes and sheet after radioiodine therapy exists a great deal of radioactive contamination. The minimum storage period calculation of patient's clothes and sheet is better suited to applying nuclide concentration offered by the regulation on self-disposal of radioactive waste. I recommend, To keep for at least 2 months of the patient's clothes and sheet contaminated radioactivity, for prevent contamination and unnecessary radiation exposure.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.65-68
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• 1998

The neuropathic pains are not well controlled by common analgesics and opioid drugs in terminal cancer patients. The types of these pains are divided within the two cages, one is due to continuous central sensitization and the other is due to paroxymal peripheral sensitization. The mechanism of continuous central sensitization is the activity of dorsal horn neurones that are activated by C-fiber input. The tricyclic antidepressants, non-tricyclic antidepressants, and oral local anaesthesia probably produce analgesic effects in neuropathic pains through suppression of this activity. The mechanism of paroxymal peripheral sensitization is the hyper-excitability of peripheral neurones. The neuropathic pains due to peripheral sensitization respond relatively the anticonvulsants and baclofen that stabilize membranes and suppress paroxymal electrical discharge. The patients was a 38-year-old female who complained of hyperthemia on upper right extremity. The symptom of this patient was improved with anticonvulsant(dilantin 600mg).

• Journal of Chest Surgery
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• v.27 no.9
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• pp.798-800
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• 1994

Chyloascities is an extravasation of milky chyle into the peritoneal cavity due to tumor , inflammation or rarely postoperative lymphatic trauma.It is an unusual complication that can lead to significant immunologic and nutritional consequences.We experienced one case of chyloascites after aorto-bifemoral bypass graft in a patient with aorto-iliac occlusive disease.The patient was a 62-year-old male, who suffered from severe progressive claudication for 5 months. A 16$\times$ 8mm gelsealed Dacron-Y shaped graft was used in arterial reconstruction. A bloody-milky fluid was drained through the operative wound from 3days after operation and evaluated biochemically.Diagnosis of chyloascites was made with repeated paracentesis and examination of the fluid.After Total parenteral nutrition[T.P.N] for 3 weeks from 6days after operation, chyloascites was controlled sufficiently and maintained a good graft-patency in abdominal sonogram.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.191-195
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• 1991

Trigeminal neuralgia(tic douloureux) is a common clinical syndrome which is characterized by a painful facial condition. The clinician must be able to identify a patient with tic douloureux because this most severe pain syndrome can almost always be controlled. Gangliolysis is the most recent development in the long history of destructive procedures for tic douloureux. H$\ddot{a}$kason pioneered a technique of placing a needle for injecting glycerol into the trigeminal cistern which he found safe and effective for pain control. In August at 1991, I injected pure sterile glycerol three times into the cistern of trigeminal ganglion using the H$\ddot{a}$rtel approach to relieve a patient from pain. The results were as follows; 1) The response of pain relief to a glycerol gangliolysis was excellent. 2) As a complication, there were mild sensory deficit, transient headache and herpes simplex around the mouth angle.