• Archives of Plastic Surgery
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• v.36 no.5
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• pp.611-616
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• 2009

Purpose: The rate of fistulas occuring followed by resection of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer are reported to be 9 ~ 23% according to various documents. Neglected treatment of the fistula can result in a setback in proper treatment with restrictions in oral intake leading to delayed return to daily life. Furthurmore, in severe cases, it may injure important vessels and adjacent structures of the neck area. The author reviewed previously reported cases of treatment methods for fistulas recurring after diverse head and neck operations and with sharing the treatment experiments of our patients, we tried to present a treatment algorism for different fistula types. Methods: Our study was based on retrograde analysis of 64 patients who were clinically diagnosed with fistula after operation for cancer of the head and neck from 1997 to 2008 at Severance Hospital. Their primary sites of cancer were 8 oral cavity, 22 oropharynx, 25 hypopharynx, and 9 larynx. The patients were aged 45 to 75 years and the male to female ratio was 11 to 1. The patient's operation records and progress notes were evaluated for determination of degree of fistula and treatment methods. Results: Most fistulas were clinically suspected after postoperative 5 days and symptoms noted for detection of the fistula were erythema, purulent discharge, edema, tenderness, and fluctuation. The fistula was definitely diagnosed at postoperative 2 weeks with barium test and treatment method ranging from conservative management to operative procedure were applied to each patients. Total 21 patients were managed with conservative protocol. In 15 cases, direct repair of the fistula was done and more stable repair of the fistula was possible with using of TachoComb$^{(R)}$. Pharyngostoma was performed in 14 patients. Among them, 4 patients healed spontaneously, 5 patients were taken direct closure, 4 patients were taken pectoralis major musculocutaneous flap, and one patient was taken esophageal transfer. The other 14 patients were taken 11 pectoralis major musculocutaneous flaps and 3 free flaps without pharyngostoma formation. Conclusion: Fistula is a troublesome complication resulting after resection of head and neck cancer. Early detection and adequate treatment according to the period and condition of the fistula may prevent further complications and reduce the pain of the patient.

• Journal of Advanced Technology Convergence
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• v.2 no.2
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• pp.23-30
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• 2023

This study is a descriptive research study conducted to find out the level of perception of the good death among nursing students and compare sub-factors among the perceptions of a good death. As for the research method, 102 people who explained the purpose of the study and agreed to participate were conveniently recruited. As a research tool, 'Measure of concept of a Good Death' by Schwartz et al. (2003) was translated by Lee (2017), and the research was conducted through online. For data analysis, statistical techniques such as descriptive statistics, frequency analysis, t-test, and one-way ANOVA of the IBM SPSS Statistics 26 program were used. Factors showing average differences in scores for each of the three sub-factors of good death awareness were derived from the experience of clinical practice. The mean of good death (3.13±0.36 points) of nursing students who experienced clinical practice was statistically significantly higher than that of students without clinical practice experience (2.90±0.31 points) (t=3.156, p=.002). In particular, the mean of good death for 'closure' was statistically significantly higher for those with experience in clinical practice (3.46±0.39 points) than those without experience (3.16±0.37 points) (t=3.476, p=.001). Through this study, it was confirmed that nursing students' perception of a good death differed depending on whether or not they were in clinical practice. The results of this study are expected to provide basic data for the establishment of effective educational strategies for the perception of good death in nursing students.

• Korean Journal of Environmental Agriculture
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• v.7 no.2
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• pp.102-110
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• 1988

This study was designed to find out whether the water quality of Lake Daeho would be suitable for Sgricultural purposes during 1984-1988 perird. Thr results were as follows ; 1. There was an apparent seasonal temperature fluctuation$(6-25^{\circ}C)$ above the entrance of the culvert at the depth of 14m, but the temperature below remained constant at $11,9^{\circ}C$. 2. The yearly water qualities observed at the deepest site by the seadike were 7.4-7.5 pH, 16,800-1,472 ${\mu}mhos/cm$ EC, 9.2-10.8ppm DO, 1.3-2.5ppm DOD, 2.4-5.3ppm COD, 0.22-2.29ppm T-N, 0.01-0.10ppm T-P. 3. The average values of water qualities at the epilimnion in 1988 were 7.6 pH, 1,745umhos/cm EC, 10.8ppm DO, 1.8ppm DOD, 2.4ppm COD, 0.52ppm T-N, 0.05ppm T-P. 4. The salinity of the epilimnion at a 6m depth was 29,000ppm before the final closure of the seadike. It was 11,000 ppm in March 1984, 4,300ppm in March 1985, 2,000ppm in March 1986 and 1987, and 900ppm in March 1988. The salinity of the whole water column decreased from 29.000ppm to 1,200 ppm in March 1988. The average salinity above and below the culvert in 1987 was about 1,300ppm, and 30,000ppm respectively reaching that of seawater. 5. The highest salinity was observed at the epilimnion by the seadike, showing about 5,835ppm in 1984. 6. The seasonal salinity fluctuation was 2,000ppm in May, 800ppm in October, and 485ppm in September 1987. 7. The halocline was observed at the depth of 14m where the entrance of the culvert was located. Therefore, the epilimnion water is suitable for agricultural purposes, and the intake of water from Lake Sapkyo seems to be unnecessary.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.649-661
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• 1999

The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

• Journal of Korean Academy of Nursing
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• v.6 no.1
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• pp.60-71
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• 1976

The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

• The korean journal of orthodontics
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• v.33 no.4 s.99
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• pp.235-245
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• 2003

The goal of the present study was to evaluate the effects of PNAM appliance and cheiloplasty on alveolar molding. Samples consisted of 16 unilateral cleft lip and palate infants (10 males and 6 female, mean age=37.0 days after birth, average alveolar cleft gap=10.46m), who were treated with PNAM appliances by one orthodontist and rotation- advancement cheiloplasty by one surgeon in Seoul National University Hospital. Average duration of alveolar molding treatment was 13.10 weeks and these patients were recalled at average 8.31 weeks after cheiloplasty. These patients' models were obtained at initial visit (T0, mean age : $37.0\pm27.89$ days after birth), after successful alveolar molding (T1, mean age : $119.25\pm40.18$ days after birth), and after cheilopasty (T2, mean age : $190.81\pm42.78$ days after birth). Seven linear and five angular variables were measured using 1 : 1 photometry and soft ware program(V-ceph. Cybermed. Seoul, Korea). Paired t-test was performed to investigate statistical significance at p<0.05 level. 1 The posterior parts of alveolar segments were the stable structures during alveolar molding treatment period and after cheiloplasty in infants. 2. The closure of cleft gap during alveolar molding was usually due to backward bending of the whole part of the greater segment. 3. Although forward growth of the greater segment was hindered by alveolar molding, it resumed after cheiloplasty. 4. Increase of anterior inter-segment angle after cheiloplasty was due to the molding effect of the lip scar pressure.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.54-61
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• 2016

Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.4
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• pp.491-499
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• 2015

Purpose: This study was to examine how decline of visual function affects visual perception by assessing visual perception after improving visual function through visual training, and observing the change in the cognitive ability of visual perception. Methods: This study analyzes the visual perceptual evaluation (TVPS_R) of 23 children below age 13($8.75{\pm}1.66$) who have visual abnormalities, and improves visual function after conducting vision training (vision therapy) of the children. Results: Convergence increased from average $3.39{\pm}2.52{\Delta}$ (prism) to $13.87{\pm}6.04{\Delta}$ in the measurement of long-distance disparate points, and from average $5.48{\pm}3.42{\Delta}$ to $18.43{\pm}7.58{\Delta}$ in the measurement of short-distance disparate points. Short-distance diplopia points increased from $25.87{\pm}7.33cm$ to $7.48{\pm}2.87cm$, and as for accommodative insufficiency, short-distance blur points increased from $19.57{\pm}7.16cm$ to $7.09{\pm}1.88cm$. In the visual perceptual evaluation performed before and after improving visual function, 6 items except visual memory showed statistically significant improvement. By order of significant improvement, response gap was highest with $17.74{\pm}16.94$(p=0.000) in visual closure, followed by $15.65{\pm}17.11$(p=0.000) in visual sequential-memory, $13.65{\pm}16.63$(p=0.001) in visual figure-ground, $12.74{\pm}18.41$(p=0.003) in visual form-constancy, $6.48{\pm}10.07$ (p=0.005) in visual discrimination, and $4.17{\pm}9.33$(p=0.043) in visual spatial-relationship. In the visual perception quotient that added up these scores, the response gap was $15.22{\pm}8.66$(p=0.000), showing a more significant result. Conclusions: Vision training enables efficient visual processing and improves visual perceptual ability. It was confirmed that improvement of visual function through visual training not only improves abnormal visual function but also affects visual perception of children such as learning, perception and recognition.

• Journal of Global Scholars of Marketing Science
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• v.18 no.1
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• pp.33-58
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• 2008

Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.