• Journal of Korean Academy of Nursing
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• v.54 no.1
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• pp.32-43
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• 2024

Purpose: This study aimed to determine the impact of an intervention using voice recording of family members on pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. Methods: A randomized control pre-post experimental design was implemented to 53 participants, with 27 and 26 participants in the experimental and control groups, respectively. A 70-second voice recording of a family member, repeated three times at 10-minute intervals was used as an intervention for the experimental group. Meanwhile, participants in the control group used headset for 30 minutes. Structured instruments were utilized to measure pain, anxiety, agitation, and the weaning process. Wilcoxon Signed Ranks test and the Mann-Whitney U test, or χ² test, were used for data analysis. Results: The experimental group exhibited significant decrease in pain (Z = - 3.53, p < .001), anxiety (t = 5.45, p < .001), and agitation (Z = - 2.99, p = .003) scores compared with those of the control group. However, there was no significant difference between groups in the weaning process' simplification (χ² = 0.63, p = .727). Conclusion: Intervention using family members' voice recording effectively reduces pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. This can be actively utilized to provide a more comfortable process for patients.

• The Journal of Advanced Prosthodontics
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• v.16 no.2
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• pp.115-125
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• 2024

PURPOSE. The purpose of this in vitro study was to investigate the fracture resistance, surface hardness, and color stain of 3D printed, CAD-CAM milled, and conventional interim materials. MATERIALS AND METHODS. A total of 80 specimens were fabricated from auto polymerizing polymethyl methacrylate (PMMA), bis-acryl composite resin, CAD-CAM polymethyl methacrylate resin (milled), and 3D printed composite resin (printed) (n = 20). Forty of them were crown-shaped, on which fracture strength test was performed (n = 10). The others were disc-shaped specimens (10 mm × 2 mm) and divided into two groups for surface hardness and color stainability tests before and after thermal cycling in coffee solution (n = 10). Color parameters were measured with a spectrophotometer before and after each storage period, and color differences (CIEDE2000 [DE00]) were calculated. The distribution of variables was measured with the Kolmogorov Smirnov test, and one-way analysis of variance (ANOVA), Tukey HSD, Kruskal-Wallis, Mann-Whitney U tests were used in the analysis of quantitative independent data. Paired sample t-test was used in the analysis of dependent quantitative data (P < .05). RESULTS. The highest crown fracture resistance values were determined for the 3D printed composite resin (P < .05), and the lowest were observed in the bis-acryl composite resin (P < .05). Before and after thermal cycling, increase in mean hardness values were observed only in 3D printed composite resin (P < .05) and the highest ΔE₀₀ value were observed in PMMA resin for all materials (P < .05). CONCLUSION. 3D printing and CAD-CAM milled interim materials showed better fracture strength. After the coffee thermal cycle, the highest surface hardness value was again found in 3D printing and CAD-CAM milled interim samples and the color change of the bis-acryl resin-based samples and the additive production technique was higher than the PMMA resin and CAD-CAM milled resin samples.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.17.1-17.8
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• 2024

Objectives: This study evaluated the effect of serum calcium, parathyroid hormone (PTH), vitamin D, and uric acid levels on pulp stone formation. Materials and Methods: Patients who were admitted to the Muğla Sıtkı Koçman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology for dental complaints were registered. Among these patients, individuals who had routine biochemical tests at the same period in the Outpatient Clinics of Muğla Sıtkı Koçman University Training and Research Hospital were included in the study. The patients with at least 1 pulp stone on panoramic radiographs recorded as the "pulp stone group" while patients without any pulp stones were the "control group". Demographic data and serum levels of calcium, PTH, vitamin D, and uric acid were retrospectively evaluated in both groups. Student t-test or Mann-Whitney U test was used to evaluate the differences between the groups. Results: Among 151 patients, dental pulp stone was detected in 53.6% of patients, and 82.7% of these patients were female. Female sex and pulp stone formation were significantly associated (p = 0.001). The mean age of the pulp stone group was 43.9, while it was 39.9 in the control group, without any significant correlation between age and pulp stone (p > 0.05). Similarly, there were no significant differences in serum levels of PTH, vitamin D, uric acid and calcium between groups (p > 0.05). Conclusions: According to the present study, the effect of dental factors rather than systemic factors should be considered primarily in pulp stone formation.

• Journal of Korean Academy of Nursing
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• v.54 no.3
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• pp.432-445
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• 2024

Purpose: This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU). Methods: This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations. Results: On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention. Conclusion: The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume.

• Journal of Society of Preventive Korean Medicine
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• v.28 no.2
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• pp.1-18
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• 2024

Objectives : This study aimed to analyze the College of Korean Medicine's education related to vaccination to examine the feasibility of Korean medical doctors administering vaccines. Methods : We conducted a comprehensive review of the guidelines from the Korea Disease Control and Prevention Agency (KDCP) and the U.S. Advisory Committee on Immunization Practices (ACIP), along with the educational standards of Korean medical colleges. From these sources, key knowledge areas essential for vaccination were identified and distilled into 12 core items, creating a checklist used to evaluate the vaccination-related education. The curricula of Korean medical colleges and online continuing education courses for Korean medical doctors were analyzed using this checklist. Additionally, we reviewed the compulsory education course for vaccination providers for comparative purposes. Results : The analysis of common textbooks from colleges of Korean medicine revealed that while basic concepts of vaccination are widely covered, practical guidance on vaccine administration is less comprehensive. Continuing education for Korean medical doctors emphasizes basic epidemiological knowledge, vaccination contraindications and treating adverse reactions, but lacks details on patient education and the vaccination process. Compulsory education for vaccination providers covers extensive administrative content and comprehensively addresses essential vaccination knowledge, including patient education and practical vaccination procedures. Conclusion : The College of Korean Medicine's curriculum covers basic vaccination theories but lacks specific training in vaccine management. Additional training can improve Korean medical doctors' vaccination skills, enhancing the healthcare system's emergency response.

• Journal of Korean Academy of Nursing
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• v.10 no.1
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.64-70
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• 2009

Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.

• Journal of dental hygiene science
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• v.10 no.2
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• pp.63-69
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• 2010

The purpose of this study was to examine the business awareness of dental coordinators and preferred working condition according to educational period, to suggest what improvements should be made. A survey was conducted for a year and four months from March 2007 to June 2008, and the collected data were analyzed, which made use of ${\chi}^2$(Chi-square) test, t-test. The findings of the study were as follows: 1. In regard to preferred conditions of employment, a dental hospital (42.0%) was most preferred by the incumbent dental hygienists investigated, followed by a dental clinic(29.4%). The largest number of the students who took dental coordinator courses had a liking for a dental hospital(41.9%), followed by university hospital and general hospital(29.0%)(p<0.001). 2. As for perception of dental coordinator, all the dental hygienists were aware of that occupation, and most of the students(81.9%) were cognizant of it(p<0.001). Concerning the necessity of that occupation, the students who felt the need for that(94.8%) outnumbered the dental hygienists who did(85.2%)(p<0.05). 65.9 percent of the dental hygienists and 84.5 percent of the students looked upon a dental hygienist as the best occupation that also could serve as a dental coordinator(p<0.01). 3. Concerning a favorite type of work including an official title, the dental hygienists wanted to work as the chief of counseling section the most(34.1%), and the largest group of the students hoped to become a section chief or team leader(35.2%). In regard to the most integral field of work, the dental coordinators(51.1%) and students(65.8%) attached the most importance to counseling(p<0.05). 4. The dental hygienists were better gratified than the students in every regard(p<0.001). The former($4.00{\pm}0.41$) looked at that occupation in a better way than the students($3.81{\pm}0.50$) as well(p<0.01). The abovementioned findings suggested that it would be advisable to provide dental hygienists with a certain level of a clinical career with education in order to ensure the success of dental coordinator education.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.513-521
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• 2018

Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.323-331
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• 2011

We evaluated clinical usefulness of Arterial spin labeling perfusion MR imaging on the acute ischemic cerebral infarction patients through this study. We compared 22 patients who were done with DSC imaging and ASL imaging in admitted emergency room with acute ischemic cerebral infarction, with 36 normal comparison persons (DSC image on 21persons, ASL images on 15persons). Siemens Magnetom Verio 3.0T with 12 channel head coil was used for this study. DSC image obtained 4 maps(rCBV, rCBF, rMTT, TTP) through post-processing. For qualitative analysis we compared the area of lesion macro-diagonal with the size of diffusion weighted MR image for rMTT, TTP, rCBF, rCBV, ASL maps. For Quantitative analysis we analyzed significant correlations between less than 3 cm infarction group and normal comparison group using mean relative value of flowing image with Mann-Whitney U test. TTP(95.5%) and rCBF(95.5%) maps showed high recognition rate in qualitative analysis for >3cm infarction group. The rCBF and rCBV map tests were highly related with final stage stroke areas. Mean relative value of infarction group showed a significant correlations in quantitative analysis(p<0.05). As a conclusion, arterial spin labeling image showed high lesion recognition rate in the >3cm infarction group. Mean relative values in quantitative evaluation were used for reference data. If we do more sustainable researches, ASL image will be useful for an early diagnosis of cerebral infarction, determination of the range of ischemic pneumbra and effective treatments.