• Journal of Gastric Cancer
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• 제5권1호
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• pp.16-22
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• 2005

Purpose: In Korea, the number of laparoscopy-assisted distal gastrectomies for early gastric cancer patients has been increasing lately. Although minimally invasive surgery is more beneficial, no reported case of a totally laparoscopic distal gastrectomy has been reported because of difficulty with intracorporeal anastomosis. This study attempts, through our experiences, to determine the feasibility of a totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy in treating early gastric carcinoma. Materials and Methods: We investigated surgical results and clinicopatholgic characteristics of eight(8) patients with an early gastric carcinoma who underwent a totally laparoscopic distal gastrectomy at the Department of Surgery, Our Lady of Mercy Hospital, The Catholic University of Korea, between June 2004 and September 2004. The intracorporeal gastroduodenostomy was performed with a delta-shaped ananstomosis by using only laparoscopic linear staplers (Endocutter 45mm; Ethicon Endosurgery, OH, USA). Results: The operative time was $369.4\pm62.5$ minutes (range $275\∼465$ minutes), and the anastomotic time was 45.1\pm14.4$ minutes (range $32\∼70$ minutes). The anastomotic time was shortened as surgical experience was gained. The number of laparoscopic linear staplers for an operation was $7.1\pm0.6$. The number of lymph nodes harvested was $31.9\pm13.1$. There was 1 case of transfusion and no case of conversion to an open procedure. The time to the first flatus was 2.8$\pm$0.5 days, and the time to the first food intake was $4.1\pm0.8$ days. There were no early postoperative complications, and the postoperative hospital stay was $10.0\pm3.9$ days. Conclusion: A totally laparoscopic distal gastrectomy using an intracorporeal gastroduodenostomy with a delta-shaped anastomosis is technically feasible and can maximize the benefit of laparoscopic surgery for early gastric cancer.

• Tuberculosis and Respiratory Diseases
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• 제49권5호
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• pp.624-632
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• 2000

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.363-368
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• 2005

Purpose : The aim of this study is to identify where and how adolescents acquire cigarettes and how many were asked for identification while purchasing cigarettes. Methods : This study was conducted in 2003; participants were 2,200 students in middle and high schools, aged from 13 to 18 years old(males 1,098; females 1,102) in Ansan, Korea. The questionnaire assured them of anonymity, and self-administered in school. The data was analyzed with chisquare test for trends. Results : The prevalence of smoking was about 20 percent among respondents, was higher in males than in females, and in older students than in younger students(P<0.001). The most frequent source of cigarettes was purchased from a store(36.3 percent). About 29.2 percent of the students borrowed from friends or family members. By sex, the main sources of cigarettes were purchase from a store and borrowing. Younger students were borrowed more cigarettes; older students purchased more cigarettes from stores. Only 48.8 percent were asked for proof of age during their purchase. Of those asked for proof of age, about 73.3 percent answered that this made it difficult to buy cigarettes(P<0.001), and they thought that it was more difficult when asked for a photo ID than simply being asked their age(P=0.019). Conclusion : So far, there has been no systemic prevention of adolescents' smoking. It is difficult for minors to purchase cigarettes if asked for proof of age, but most minors go to stores to purchase cigarettes. Therefore, prevention efforts should include educating retailers not to sell cigarettes to minors and enforcing existing laws requiring youth to provide proof of age when attempting to buy cigarettes.

• Journal of Chest Surgery
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• 제36권7호
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of Hospice and Palliative Care
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• 제1권1호
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• pp.56-64
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• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• Information Systems Review
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• 제14권1호
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• pp.85-103
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• 2012

ISMP is a method of writing clearly the user requirements in the RFP(Request for Proposal) of the IS development projects. Unlike the conventional methods of RFP preparation that describe the user requirements of target systems in a rather superficial manner, ISMP systematically identifies the businesses needs and the status of information technology, analyzes in detail the user requirements, and defines in detail the specific functions of the target systems. By increasing the clarity of RFP, the scale and complexity of related businesses can be calculated accurately, many responding companies can prepare proposals clearly, and the level of fairness during the evaluation of many proposals can be improved, as well. Above all though, the problems that are posed as chronic challenges in this field, i.e., the misunderstanding and conflicts between the users and developers, excessive burden on developers, etc. can be resolved. This study is a case study that analyzes the execution process, execution accomplishment, problems, and the success factors of two pilot projects that introduced ISMP for the first time. ISMP performance procedures of actual site were verified, and how the user needs in the request for quote are described was examined. The satisfaction levels of ISMP RFP for quote were found to be high as compared to the conventional RFP. Although occurred were some problems such as RFP preparation difficulties, increased workload, etc. due to the lack of understanding and execution experience of ISMP, in overall, also occurred were some positive effects such as the establishment of the scope of target systems, improved information sharing and cooperation between the users and the developers, seamless communication between issuing customer corporations and IT service companies, reduction of changes in user requirements, etc. As a result of conducting action research type in-depth interviews on the persons in charge of actual work, factors were derived as ISMP success factors: prior consensus on the need for ISMP, the acquisition of execution resources resulting from the support of CEO and CIO, and the selection of specification level of the user requirements. The results of this study will provide useful site information to the corporations that are considering adopting ISMP and IT service firms, and present meaningful suggestions on the future study directions to researchers in the field of IT service competitive advantages.

• The korean journal of orthodontics
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• 제35권1호
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• pp.60-68
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• 2005

The evaluation of malocclusion has to be done quantitatively and qualitatively. This will be lead toward an analysis of malocclusion severity as well as treatment difficulty. The method of proper evaluation of malocclusion severity and treatment difficulty is necessary to assess treatment effect and efficiency for the orthodontists and to establish fundamentals for planning and executing the health-related policies in private and public institutions. The purposes of this study as the first part of the objective and quantitative analysis of malocclusion were 1) to measure treatment difficulty based on the opinions of several orthodontists. and 2) to investigate the relationships between objective malocclusion severity and subjective treatment difficulty 100 pairs of dental casts that had various types and severity of malocclusion were selected from the orthodontic departments of Kyurghee University and Samsung Medical Center The objective malocclusion severity was measured with the PAR (Peer Assessment Rating) index and the subjective treatment difficulty was evaluated by 8 experienced orthodontists. The relationships between objective malocclusion severity and subjective treatment difficulty were statistically evaluated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty especially in the measurements of the upper anterior alignment, the buccal occlusion. the overjet, the overbite and the midline discrepancy en the malocclusion components. The results of this study can provide the background knowledge to develop a new occlusal index. which contains both the malocclusion severity and treatment difficulty for Korean orthodontists.

• The Journal of Korean Academy of Sensory Integration
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• 제9권2호
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• pp.1-13
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• 2011

Objective : Purpose of this study is to discuss benefits and implications of the clinical reasoning process and re-evaluation in the OTIPM by introducing a single case that occupational therapy intervention is provided based on the OTIPM. Methods : The case subject is a boy aged 5 years and 10 month who had diagnosed as attachment disorder and anxiety disorder from a pediatric psychiatrist before. The boy is referred to sensory integration therapy clinic and underwent occupational therapy intervention service twice a week for four month. Therapeutic activities for the intervention were consisted of sensory integration activities for restorative model, care-giver education for educational model, and performance skill training for acquisitional model. Measurements used in the initial evaluation are JSI-R, DDST-2, Social Maturity Test, KPPS-R, and observation-based performance task analysis. For the performance task analysis, performance skill items were constructed based on the Occupational Therapy Process Framework (OTPF), and those were assessed by the evaluation system of Assessment of Motor and Process Skill (AMPS) and Evaluation of Social Participation (ESI). Results : The detail process of implementing of the OTIPM in this study is reported by following four phases; 1) establish client-centered performance context; 2) establish baseline and interpret cause (initial evaluation); 3) intervention planning and implementing; and 4) recognize intervention outcome (reevaluation). Conclusion : In this case, occupational therapist could provide the client an occupation-based intervention within comprehensive performance context based on the OTIPM. Therapist could clearly identify the cause of problematic performance skills and behaviors and so provide effective intervention to improve client's occupational performance. Additionally, it was found that client's satisfaction of the intervention can be raised when the concept of 'who is the client' is expanded based on the OTIPM. From this study, it is proposed that OTIPM may be a model educible 'comprehensive' enhancement of 'specific' occupational engagement, as it considers both improvement of occupational performance and satisfaction.

• Journal of the Korean Academic Society of Industrial Cluster
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• 제1권1호
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• pp.67-86
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• 2007

Wonju Medical Equipment Industry, despite of its short history, poor sales and weak manpower and so on, have shown remarkable outcomes in a relatively short period. At the end of 2007, totally 79 enterprises (only 4.6% of whole enterprises in Korea) made 10% of the nationwide production and 15% of the nationwide exports with an annual average growth rate of 66.7%, contributing domestic medical equipment industry tremendously. In addition, many leading medical equipment enterprises in various fields already moved or plan to move to Wonju, accelerating Wonju Medical Equipment Cluster. Wonju Medical Equipment Industry Cluster now enters into the growth stage, getting out of the initial business setup stage. Especially, the nomination of Wonju cluster project from the government accelerates networking (e.g. the development of the universal parts, the establishment of the mutual collaboration model among enterprises, and the mutual marketing), making a rapid growth in Wonju Medical Equipment Industry. Wonju Medical Equipment Industry Cluster revealed positive outcomes despite of the weakness in investment size and infra-structure comparing with the other medical industry cluster in the advanced country, while many domestic enterprises pursued their own growth models and thus failed to promote the international competitive power. Wonju Medical Equipment Industry has been developed rapidly. However, there are many challenging problems to support enterprises: small R&D investment and thus weak technology power, difficulties in recruiting R&D engineers, and poor marketing capabilities, financial infrastructure & policies, and network architecture. In order to develop a world-competitive medical equipment industry cluster at Wonju, the complement of infrastructures, the technology innovation, the mutual marketing, and the network expansion to support enterprises are further required. Wonju' s experiences in developing medical equipment industry so far suggest that our own flexible cluster model considering the industry structure and maturity for different regions should be developed, and specific action plans from the local and central governments based on their systematic strategies for industry development should be implemented in order to build world-competitive industry clusters in Korea.

• Journal of the Korean Institute of Landscape Architecture
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• 제39권3호
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• pp.64-73
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• 2011

This study starts from the hypothesis that the information society has affected the layman's interpretation and production of content. Specifically, the manner and contents of communication concerning the landscape of Soonyoo-do Park in blogs are surveyed and the possibilities and limitations of this phenomenon are discussed. The following topics are dealt with. Firstly, what is the landscape of Seonyoodo Park as captured by bloggers? What type of landscape do bloggers respond to? Secondly, what is the unique way that bloggers capture and interpret the landscape? Thirdly, What are the possibilities and limitations discovered from the landscape as captured and interpreted by bloggers? Thus, 1,000 blog posts concerning Soonyoo-do Park, as culled from the Internet, were categorized into three areas, First are blog posts browsed by keywords such as 'photo', 'a photographer's visit', 'a good p1ace for taking photos', and 'landscape'. These are focused on the visual aspects of the landscape. The second category is posts under the keywords 'domestic travel', 'Seoul travel', 'travel', and 'recommendation'. They contain introductory information on Seonyoodo Park; that is, they focus cm the more utilitarian functions of Seonyoodo Park as a place. The third one is posts that record personal experiences. The subjects for photography are the bloggers themselves and their companions. As a result of studying the way bloggers deal with landscape, it was found that first, people have developed the ability to capture the landscape and interpret the landscape actively and independently. This process can be regarded as the reproduction of landscape and place. In addition, the recording of their appreciation and feeling overlaps with evaluation and assumption. One negative aspect, however, is that many bloggers dramatize and repeat similar scenes. This can be seen as a make-up of image. The limitations of this study include difficulty in interpretation because blogs, which are the objects of this study, are very subjective and personal. In addition, it was not easy to categorize posts because there were diverse images and a broad range of writing. Nevertheless, practitioners of landscape architecture should continue to monitor and use one-person media like blogs, because the relationship between modern man and the landscape can be better understood through them.