• 대한통합의학회지
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• 제2권2호
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• pp.41-47
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• 2014

Purpose : The aim was to compare the implant success rate according to membrane type through a clinical case of patients, who used bio-resorbable membrane and non-resorbable membrane. Methods : A survey was conducted targeting patients with the use of bio-resorbable membrane and non-resorbable membrane who visited H dental clinic in Busan for implant surgery and bone graft for 1 year from May 2010 to May 2011. A chart was made and surveyed for 100 people with non-resorbable membrane and for 75 people with bio-resorbable membrane. Results were compared. Results : 1. As for the measurement value of Periotest M${(R)}$, the value of -8~0 was measured with 92% in case of surgery by using non-resorbable membrane. The value of +1~+9 was measured with 8.0%. In case of surgery by using bio-resorbable membrane, Peiotest M(R) was measured with 78.7% as for the value of -8~0 and 16(21.3%) as for the value of +1~+9. In light of this, a case of using non-resorbable membrane was indicated to be higher(p=0.021) in success rate than a case of using bio-resorbable membrane. 2. As a result of periodontal conditions, namely, bleeding(p=0.914), swelling(p=0.500), inflammation(p=0.074), pain(p=0.571), and itch appearance(p=0.475) according to membrane type, all were insignificant. Conclusions : A case of using non-resorbable membrane is considered to be likely to be more effective than using bio-resorbable membrane during GBR(Guided Bone Regeneration) with the use of membrane in implant surgery.

• 한국학교보건학회지
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• 제29권3호
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• pp.167-179
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• 2016

Purpose: This study was performed to analyze the job of school health teachers working at high schools in Seoul, using DACUM (Developing a curriculum), a method for analyzing job-focused competency. Methods: A DACUM workshop was held to define school health teachers' role and identify their duties and tasks. For the workshop, a committee was organized, consisting of 5 school health teachers. Finally, the developed contents, after validation, were made into a survey asking about school health teacher's duties and tasks and the survey was carried out on 37 school health teachers. Results: 14 duties and 90 tasks were identified on the DACUM chart. The importance, difficulty, and frequency of the tasks were represented with ${\alpha}$ bet A, B, and C, with A being the highest degree. The duty with the biggest determinant coefficient (DC) was 'management of emergency patients' (DC=7.95), while the lowest was 'management of health clinic supplies' (DC=4.33). In terms of tasks, the one with the biggest DC was 'conducting physical assessment for emergency patients' (DC=7.8), followed by 'conducting health classes' (DC=7.79). 'Supervising school lunch' (DC=2.02) and 'supervising self-study' (DC=2.42) were the tasks with the smallest and the second smallest DC. Conclusion: The results of the study show that school health teachers'job expanded to include preventive activities such as health education, health counseling, and health promotion activities. The results of this study can serve as basic data for developing training programs for school health teachers as well as an evaluation-scale to measure school health teachers' job performance.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.61-69
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• 1997

The submandibular gland is one of the major salivary glands, salivary diseases frequently occuring site due to its anatomical weakness. This retrospective study evaluated data pertaining to history, sex, operation method, age distribution, diagnosis through the chart, operation record, radiographs, histologic finding of 51 patients operated on for the submandibular gland excision from 1986 to 1995 in our hospital so that we improve on the understand of the salivary gland diseases. The results were as follows ; 1. The chief complaints was mass, swelling mainly. 2. The ratio of affected site was 47.1 : 51 in left : right respectly, both sites was 1 case especially. 3. The ratio of men to women was 56.9 : 43.1 4. The operation performed all through the extraoral approach. 5. The sialolith presented at 24 cases. 6. The most patients had a two weeks duration period. 7. The age distribution was the third decade(29.4%), the second decade(27.5%) in order. 8. The symptoms accompanied the chief complaints was pain(37.3%), mass(17.6%), swelling(13.7%), trismus(13.7%) in order. 9. The diagnosis was sialadenitis with stone(S.W.S.) (45.1%), sialadenitis without stone(S.W.O.S.) (17.6%), pleomorphic adenoma(P.A.) (15.7%), abscess(Abs) (5.9%), tuberculosis(Tbc) (5.9%) in drder.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.109-116
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• 2000

Objectives : Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. Methods : A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. Results : Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. Conclusions : This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.

• Journal of Chest Surgery
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• 제36권8호
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• pp.590-594
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• 2003

혈관 손상은 외부 활동이 많아지기 때문에 점차 증가되는 추세에 있다. 그러나 혈관 손상에 대한 연구는 흔하지 않다. 혈관의 외상성 손상과 예후의 관계에 대하여 알아보고자 하였다. 대상 및 방법: 경상대학교병원 흉부외과에서 1992년에서 1999년까지 혈관외상으로 수술을 시행한 44명의 환자를 대상으로 하였다. 환자의 의무기록을 중심으로 전향적인 분석을 시행하였다. 저자들은 혈관 손상의 원인, 치료, 예후에 관하여 조사하였다. 결과: 외상이 발생한 후 응급실로 내원한 시간은 평균 3.5시간이었고, 수술 시작에 걸린 시간은 평균 8.8시간이었다. 5예에서는 사지의 절단을 필요로 하였으며, 절단을 필요로 한 모든 환자는 분쇄골절을 동반한 환자였다. 38명의 환자는 다른 손상과 동반되어 혈관손상이 발생하였고, 대부분의 동반 손상은 근육과 신경 손상이었다. 걸론: 혈관 손상의 최선의 치료 계획은 손상 후 즉각적으로 진단하고 빨리 치료하여야 사지의 절단율을 낮추고, 외상 후 후유증을 줄일 수 있다. 그러므로 응급 상황에서 다발성 외상 환자를 평가할 때 조심하여 혈관 손상을 조기에 진단하고 빨리 수술할 수 있도록 하여야겠다.

• Journal of Chest Surgery
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• 제14권3호
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• pp.228-234
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• 1981

Measurement of cardiac output by thermodilution method is easy to perform and can be repeated at very short intervals and offers a number of theoretical and practical advantages. The purpose of this paper is to reevaluate the accuracy and reproducibility of the thermodilution cardiac output by comparing the results with those obtained by the direct Fick technique. From January through April 1981 [4 months], 26 simultaneous cardiac output measurements were made using thermodilution and direct Fick methods in 12 patients in the intensive care unit of Severance Hospital following open heart surgery. The average age of the patients was $34.8{\pm}12.0$ [SD] years [range; 17-57 years]. For cardiac output determination by thermodilution technique [$CO_TD$], a Swan-Ganz Thermodilution Catheter, Model 93A-131-7F [Edwards Laboratories], a Cardiac Output Computer, Model 9520A, and Strip Chart Recorder, Model 9810 [Edwards Laboratories] were used. For the determination of cardiac output by direct Fick principle [$CO_Fick$], a Van Slyke Manometric Apparatus [Thomas] for the measurements of arteriovenous oxygen content difference and a Collin`s Respirometer with Kymograph for the measurement of oxygen consumption were used. The correlation between the simultaneously measured $CO_TD$ and $CO_Fick$ was found to be $CO_Fick$ = 0.95.$CO_TD$ + 0.1073, [r= 0.9777, P < 0.001 ]. For 26 double or triple determinations of $CO_TD$, the values ranged from 1.77 L/min to 6.66 L/min, with a reproducibility of 2.18%. The maximum difference of $CO_TD$ for $CO_Fick$ was between +11.99% and -12,99% [$Mean{\pm}SD$ = $6.07{\pm}3.97$%]. Measurement of cardiac output by thermodilution method provides a simple, rapid, reproducible and highly accurate method for multiple cardiac output measurements suitable for use at the bedside. Comparison of Cardiac Output Determination by Direct Fick and Thermodilution Method in Man.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.29-36
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• 2016

Purpose: Skin grafting is used for the transfer of cutaneous tissue from one site of the body to another. To improve graft survival, close contact between the graft and the wound bed is essential for vessels to grow across the gap. Here, we introduce an easy and efficient dressing method to improve graft survival. Materials and Methods: A retrospective chart review was performed to identify patients who underwent split thickness skin graft and negative pressure wound therapy (NPWT) or conventional treatment between January 2007 and April 2015. Overall, 25 consecutive patients were included in the NPWT group and 49 were included in the conventional dressing group to compare the outcome of the procedure. The data were obtained from medical records, including age, sex, cause of the skin defect, size of graft, time for healing, wound preparation time, and complications. Results: Of the NPWT group, the average wound size was $147.04{\pm}146.74cm^2$ (range, $9{\sim}900cm^2$). With the exception of one patient, all wounds healed without the need for further procedure. The average duration of time required for the NPWT group, which was defined as removal of stitches (or staples) and no need for additional active dressing, was $6.4{\pm}1.97days$ (range, 5~15 days). The average time for the conventional dressing group was $10.78{\pm}2.38days$ (range, 5~15 days). Conclusion: NPWT can be used to cover regions in which wound healing does not occur fully or when neither tie-over nor compressive dressings are applicable. This treatment also reduced wound healing time and allowed earlier patient mobilization and hospital discharge.

• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.178-185
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• 2014

Purpose: Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods: We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results: Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively). Conclusion: Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.

• 기본간호학회지
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• 제6권1호
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• pp.51-63
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• 1999

This study examined two differences in physical and psychological recovery patterns after surgery in the elderly. The sample consisted of 40 patients with abdominal surgery In five large hospitals in Seoul. The data for this study were collected from Apr. 20 to Nov. 26 by structured questionnaire, chart review and call. Physical recovery was assessed by ADL, a Cantril Ladder Scale and a Visual Analogue Scale. Psychological recovery was measured by the Geriatric depression Scale and a Cantril Ladder Scale. The data were analyzed using frequency, percentage, Pearson Correlation Coefficient, and MANOVA by SPSS/WIN. The result are as follows : 1. Physical recovery indicated significant improvement over time with the exception of ADL(F=.812 p=.449). Perceived physical health were significantly improved(F=6.189 p=.004). Pain & discomfort was significantly decreased(F=3.927 p=.025). 2. Perceived psychological health was significantly improved over time(F=20.648 p=.000), but depression showed no statistical significance improvement over time(F=1.393 p=.256). 3. There were no significant effects of sex, age, complication and combined chronic diseases on physical and psychological recovery patterns. 4. There were significant correlations between operation time and pain(r=-.331 p=.020), recovery time and perceived psychological health(r=-.320 p=.024), recovery time and pain(r=.404 p=.005). There were significant correlations between admision period and ADL(r=-.418 p=.004), perceived physical health(r=-.354 p=.014), depression(r=.280 p=.042), and perceived psychological health(r=-.447 p=.002). BRAS showed significant correlation with ADL(r=-.458 p=.002). 5. With an increase in the degree of perceived health(physical and psychological), ADL was significantly increased. With an increased in the degree of depression and pain, ADL and perceived health(physical and psychological) were significantly decreased. In conclusion, the elderly patient recovered significantly over time with the exception of ADL and depression. It these we suggested to considered when planning care for elderly patients.

• 한국임상약학회지
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• 제8권1호
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• pp.35-46
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• 1998

A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.