• Journal of Convergence for Information Technology
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• v.9 no.9
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• pp.27-32
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• 2019

Along with the growth of u-Healthcare, we propose a security enhancement based on network separation for CloudHIS with for handling healthcare information to cope with cyber attack. To protect against all security threats and to establish clear data security policies, we apply desktop computing servers to cloud computing services for CloudHIS. Use two PCs with a hypervisor architecture to apply physical network isolation and select the network using KVM switched controller. The other is a logical network separation using one PC with two OSs, but the network is divided through virtualization. Physical network separation is the physical connection of a PC to each network to block the access path from both the Internet and the business network. The proposed system is an independent desktop used to access an intranet or the Internet through server virtualization technology on a user's physical desktop computer. We can implement an adaptive solution to prevent hacking by configuring the CloudHIS, a cloud system that handles medical hospital information, through network separation for handling security enhancement.

• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.74-83
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• 2019

Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

• Journal of Korean Academy of Nursing
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• v.49 no.2
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• pp.149-160
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• 2019

Purpose: The purpose of this study was to examine the effects of oral cryotherapy on oral mucositis, reactive oxygen series, inflammatory cytokines, and oral comfort in patients undergoing chemotherapy for gynecologic cancers. Methods: Participants were randomly assigned to the experimental group (n=25, receiving oral cryotherapy during chemotherapy) and the control group (n=25, receiving the usual care consisting of 0.9% normal saline gargles three times before meals). Oral mucositis was assessed using the oral assessment guide, while oral comfort was assessed using the oral perception guide. Reactive oxygen series was measured as total oxidant stress, and the level of two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor-alpha ($TNF-{\alpha}$), were examined. The data were analyzed using t-test, chi-square test, Fisher's exact test, Mann-Whitney U-test, and repeated measures analysis of variance. Results: There was a significant difference in the oral mucositis score, reactive oxygen series score, $TNF-{\alpha}$ level, and oral comfort score between the two groups, and there were significant changes over time and in the group-by-time interactions. There was a significant difference in the IL-6 score between the two groups, but there were no significant changes over time or in the group-by-time interactions. Conclusion: The study results revealed that oral cryotherapy was more effective than the usual care regime of normal saline gargles for reducing oral mucositis, reactive oxygen series, and inflammatory cytokines and for improving oral comfort in gynecologic cancer patients undergoing chemotherapy.

• BLOOD RESEARCH
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• v.53 no.4
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• pp.314-319
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• 2018

Background Iron overload is a risk factor affecting all patients with thalassemia intermedia (TI). We aimed to determine whether there is a relationship of serum ferritin (SF) and alanine aminotransferase (ALT) with liver iron concentration (LIC) determined by R2 magnetic resonance imaging (R2-MRI), to estimate the most relevant degree of iron overload and best time to chelate in patients with TI. Methods In this cross-sectional study, 119 patients with TI (mean age years) were randomly selected and compared with 120 patients who had a diagnosis of thalassemia major (TM). Correlations of LIC, as determined by R2-MRI, with SF and ALT levels, were assessed in all participants. A P-value <0.05 was considered statistically significant. Results SF and LIC levels were lower in patients with TI than in those with TM; only ferritin values were significant. We found a statistically significant relationship between SF and LIC, with cut-off estimates of SF in patients with TI who had splenectomy and those who entered puberty spontaneously (916 and 940 ng/mL, respectively) with LIC >5 mg Fe/g dry weight (P<0.0001). A significant relationship was also found for patients with TI who had elevated ALT level (63.5 U/L), of 3.15 times the upper normal laboratory limit, using a cut-off for LIC ${\geq}5mg\;Fe/g\;dry\;weight$. Conclusion We determined the cut-off values for ALT and SF indicating the best time to start iron chelation therapy in patients with TI, and found significant correlations among iron overload, SF, and ALT.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.341-347
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• 2020

Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

• The Korean Journal of Health Service Management
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• v.13 no.3
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• pp.163-172
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• 2019

Objectives: With the rapidly increasing incidence of cancer worldwide, it has become important for health care professionals to both provide care for cancer patients and to address the challenges faced by family caregivers of cancer patients. This study aims to identify the factors affecting depression among cancer patients' family caregivers. The results of this study suggest the need to propose programs for family caregivers as well as cancer patients. Methods: Participants were 219 caregivers who were informed of the study purpose and agreed to participate. Data were analyzed using t-tests, one-way ANOVA, Scheffe's test, Pearson correlation coefficients, and multiple stepwise regression with the SPSS/WIN 25.0 program. Results: The mean score for depression among cancer patients' family caregivers was $1.57{\pm}.40$ (range: 0-3). Depression was significantly different based on age, relationship with the patient, education, occupation, cancer recurrence, care days per week, financial burden, site of cancer, and health status. Analysis using multiple regression showed that model 1 showed 16% of the factors predicting depression among cancer patients' family caregivers (F=6.16, p<.001) including occupation, recurrence, and health status of the caregiver. Model 3, which included additional burnout, showed 37% of the factors predicting depression (F=12.36, p<.001). Conclusions: These results suggest that it is necessary to develop programs for prevention and management of depression among cancer patients' family caregivers.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.87-97
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• 2021

Purpose: This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening. Methods: This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test. Results: Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031). Conclusions: After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

• Journal of English Language & Literature
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• v.54 no.4
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• pp.483-509
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• 2008

For the last decades, criticism on Frankenstein has tried to make a link between Victor's Creature and Rousseaurean "man in a state of nature." Like the Rousseaurean savage in a state of animal, the monster has only basic instincts least needed for his survival, i.e. self-preservation, but turns into a civilized man after learning language. Most critics argue that, despite the monster's acquisition of language, his failure in entry into a cultural and linguistic community is the outcome of a lack of sympathy for him by others, which displays the stark existence of epistemological barriers between them. That is to say, the monster imagines his being the same as others in the pre-linguistic stage but, in the linguistic stage, he realizes that he is different from others. Interpreting the Rousseaurean idea of language, which appears in his writings, as much more focused on emotion than many critics think, I read the dispute between Victor and his Creature as a variation of parent-offspring conflict. Shelley criticizes Rousseau's parental negligence in putting his children into a foundling hospital and leaving them dying there. The monster's revenge on uncaring Victor parallels the likely retaliation Rousseau's displaced children would perform against Rousseau, which Shelley imaginatively reproduces in her novel. The conflict between the monster and Victor is due to a disrupted attachment between parent and child in terms of Darwinian developmental psychology. Affective asynchrony between parent and child, which refers to a state of lack of mutual favorable feelings, accounts for numerous dysfunctional families. This paper shifts a focus from a semiotics-oriented perspective on the monster's social isolation to a Darwinian perspective, drawing attention to emotional problems transpiring in familial interactions. In doing so, it finds that language is a means of communicating one's internal emotions to others along with other means such as facial expressions and body movements. It also demonstrates that how to promote emotional well-being in either familial or social relationships entirely depends on the way in which one employs language that can entail either pleasure or anger on hearers' part.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.136-140
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• 2020

Purpose: The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied. Methods: This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher's exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality. Results: One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis. Conclusion: The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.

• Phonetics and Speech Sciences
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• v.14 no.3
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• pp.11-25
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• 2022

From simultaneous recordings of the external photoglottography, intra-oral air pressure (P_io), airflow and acoustic data from four native Seoul Korean speakers (2 male and 2 female), we have found that the two fricatives are not significantly different in glottal opening peak and airflow peak height either word-initially or word-medially and that the duration of aspiration is significantly reduced in word-medial /s/, compared to those in word-initial /s/, not in /s'/. We have also found that the duration of a high P_io plateau is significantly longer in /s/ than in /s'/ both word-initially and word-medially and that airflow resistance (R=P_io/U) at the onset and offset of a P_io plateau and at the time of airflow peak height is significantly higher in /s'/ than in /s/ across the contexts. However, the differences in P_io peak and F0 are not significant. In addition, the transition time to reach airflow peak height from the offset of a P_io plateau is found to be significantly longer in /s/ than /s'/ in both word-initial and word-medial positions. No significant differences in glottal opening peak and airflow peak height confirm that /s/ is specified as [-spread glottis] like /s'/. As for the other significant differences, we propose that /s/ is [-tense], and /s'/ [+tense].