• Archives of Plastic Surgery
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• v.34 no.6
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• pp.697-704
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• 2007

Purpose: The objective of the study is to identify plastic surgeons' views on the effects of online communication between doctors and patients.Methods: Cross-sectional online survey of members of the Korean Society of Plastic and Reconstructive Surgeons was made to identify their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. A questionnaire with 25 items was sent to the surgeons' e-mails, and 111 replied. SPSS Win version 12.0 was used to analyze the statistical differences and meanings among data.Results: The percentage of the plastic surgeons who were experiencing the online communication was 65.8%, and the most frequent medium used was homepage of the clinic/hospital. Even though the percentage of the plastic surgeons who were using the online communication for their everyday practice was high, the percentage of patients who visited the clinic/hospital after using the website of the clinic/hospital was relatively low. The effects of online communication on doctor-patient relationship were neutral in 40(36.0%) and positive in 39(35.1%). The effects on the efficiency of the practice was positive in 45(40.5%), and the effects on the quality of care and the patients' outcome were positive in 46(41.4%) respectively.Conclusion: The ratio of surgeons who are experiencing the online communication is relatively high, whereas the ratio of patients who are using online communication is low. Most of plastic surgeons are positive on the effects of the online communication on doctor-patient relationship, quality of care, and patients' outcome.

• Informatization Policy
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• v.18 no.1
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• pp.24-44
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• 2011

The evolution of cloud computing over the past few years is potentially one of the major advances in information technology. However, if cloud computing is to achieve its potential, there needs to be a clear identification and understanding of the various issues involved, both from the perspectives of the providers and the consumers of the technology. While a lot of research is currently taking place in the technology itself, there is an equally urgent need for understanding the business-related issues surrounding cloud computing service. As more and more information on individuals and companies are placed in the cloud service, concerns are beginning to grow about just how safe and reliable an environment it is. For successful implementation of cloud services, it is necessary to establish the certification systems to ensure the safety and reliability of cloud services. This paper provides a safe and reliable framework for cloud service certification systems. In order to develop it, the critical issues related to service quality and certification of cloud services have been identified and the systematic framework for certification systems of cloud services and service provider domains have been developed. An evaluation method for the developed certification systems is also proposed.

• Korean Journal of English Language and Linguistics
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• v.3 no.1
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• pp.37-54
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• 2003

The purpose of this paper is to investigate the phenomena of preposing and inversion in English from the discourse-pragmatic perspectives. We claim that different types of preposing can be unified to a single process of topicalization. We also show that diverse discourse functions of inversion can be subsumed under the ‘linking’ function with the prior discourse. It is followed a comparative discussion between preposing and inversion to find what similarities the two constructions share and what differences there exist between the two. It is concluded that the choice of a syntactic forms ultimately depends on the speaker's evaluation of the information status of the knowledge store of the hearer.

• Journal of Ecology and Environment
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• v.44 no.3
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• pp.162-177
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• 2020

Background: Ecologists have achieved much progress in the study of mechanisms that maintain species coexistence and diversity. In this paper, we reviewed a wide range of past research related to these topics, focusing on five theoretical bodies: (1) coexistence by niche differentiation, (2) coexistence without niche differentiation, (3) coexistence along environmental stress gradients, (4) coexistence under non-equilibrium versus equilibrium conditions, and (5) modern perspectives. Results: From the review, we identified that there are few models that can be generally and confidently applicable to different ecological systems. This problem arises mainly because most theories have not been substantiated by enough empirical research based on field data to test various coexistence hypotheses at different spatial scales. We also found that little is still known about the mechanisms of species coexistence under harsh environmental conditions. This is because most previous models treat disturbance as a key factor shaping community structure, but they do not explicitly deal with stressful systems with non-lethal conditions. We evaluated the mainstream ideas of niche differentiation and stochasticity for the coexistence of plant species across salt marsh creeks in southwestern Denmark. The results showed that diversity indices, such as Shannon-Wiener diversity, richness, and evenness, decreased with increasing surface elevation and increased with increasing niche overlap and niche breadth. The two niche parameters linearly decreased with increasing elevation. These findings imply a substantial influence of an equalizing mechanism that reduces differences in relative fitness among species in the highly stressful environments of the marsh. We propose that species evenness increases under very harsh conditions if the associated stress is not lethal. Finally, we present a conceptual model of patterns related to the level of environmental stress and niche characteristics along a microhabitat gradient (i.e., surface elevation). Conclusions: The ecology of stressful systems with non-lethal conditions will be increasingly important as ongoing global-scale climate change extends the period of chronic stresses that are not necessarily fatal to inhabiting plants. We recommend that more ecologists continue this line of research.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.236-241
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• 2015

Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

• Journal of Elementary Mathematics Education in Korea
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• v.18 no.2
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• pp.341-355
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• 2014

The purpose of this study was to analyze the research trends of elementary mathematics education in Japan. For this purpose, 192 papers published by Japan Society of Mathematics Education for the last 10 years(2004-2013) were analyzed according to there criteria. First, as for research topics, the frequent topics in order were instructional design and methods (36.7%), analysis of curriculum and textbook, general studies, learners' perspectives and abilities, evaluation, teacher education, education engineering and parish. Second, the contents were researched by the order of number and operations (47.4%), geometry, regularity, measurement and probability and statistics. Finally, research subjects of this study were researched by the order of students(39.3%), teachers. Papers dealing with lower graders as well as pre-service teachers were rare. And article dealing with low-achievers and gifted students were not founded. On the basis of this result, we hope it will provide the follow-up and the idea of the elementary mathematics education in Korea and also help various and balanced development.

• Perspectives in Nursing Science
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• v.15 no.1
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• pp.29-40
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• 2018

Purpose: The present study aimed to review the characteristics of cognitive behavioral therapy (CBT) programs for alcohol use disorders and to examine the outcomes of such programs. Methods: We searched for domestic and foreign studies that implemented a CBT program for alcohol use disorders, published from 2006 to 2017. Studies that met inclusion/exclusion criteria were selected and a quality assessment was performed using the Risk of Bias (RoB) and Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) instruments. We utilized a five-stage analysis process, through which nine experimental studies were selected. Results: Of these nine studies, four were randomized controlled trials, four used a quasi-experimental design, and one used a qualitative design. The CBT involved the three domains of cognitive reconstruction, problem solving, and coping. Coping with drinking situations and communication constituted most of the sessions. The outcomes of such interventions showed that CBT had a positive effect on alcohol use and self-evaluation. Conclusion: CBT is an effective way to change alcohol use behaviors, motivation, interpersonal relationships, emotional control, and self-efficacy among patients with alcohol use disorders. This study provides evidence for the effectiveness of CBT-based programs for the treatment of alcohol use disorders.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.231-240
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• 2018

Background: Analyses of the efficacy and safety of transcatheter aortic valve replacement (TAVR) in most countries have been based on outcomes obtained in accordance with national practice guidelines and monitoring protocols. The purpose of this study is to share our experience regarding the process for establishing guidelines and monitoring protocols for the use of TAVR in Korea, in the hopes that it may be helpful to others undergoing a similar process in their own country. Methods: The Korean guidelines for TAVR were established on June 1, 2015 in through a tri-party agreement involving the Department of Health and Welfare, the Korean Society of Thoracic and Cardiovascular Surgery and the Korean Society of Cardiology. We agreed to monitor the guidelines transparently and to exchange opinions regarding amendments or continuation of its contents after 3 years of monitoring. Results: The monitoring meetings were not held as regularly as agreed, and monitoring was also made difficult by insufficient and incomplete data. Nevertheless, during the meetings, measures to improve the monitoring process were discussed, and accordingly, an agreement was made to continue the monitoring process, with the aim of completing data collection by 2018. Conclusion: Compliance with guidelines is critical for assessing the efficacy and safety of TAVR. Moreover, the TAVR monitoring process must be properly conducted for an accurate evaluation to be made. Any country planning to introduce TAVR may encounter difficulties with regards to the optimal initiation strategy and subsequent monitoring. Nevertheless, continued efforts should be made to persuade the government and the corresponding medical societies to facilitate the optimal application of TAVR.

• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.193-199
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• 2010

Tacrolimus, an immunosuppressant prescribed against graft-versus-host disease (GVHD) in patients with allogeneichematopoietic stem cell transplantation (HSCT), is affected to change its pharmacokinetic properties by various factors. For this reason, it is needed a close monitoring to adjust dosage amount in order to optimize the blood concentration of tacrolimus is located within the effective range. According to our in-house study, 62% of HSCT-patients were needed dosage-adjustment and it is necessary to optimize the current immunosuppressive regimen in clinical settings. A retrospective study was designed to evaluate the dosing regimen (converting ratio of IV:PO=1:4) of tacrolimus in HSCT patients (n=62). After collecting data from patient's profile and medical record, pharmacokinetic parameters were calculate and compared between the estimated and the actual values in the selected subjects (n=58). It was found that the bioavailabilty (BA) of oral tacrolimus was 40.5% very much different from that is known as 25%. It implies that the current protocol has a potent risk causes dose-related toxicities to the patients. Furthermore, analyses among factors demonstrated that there was no statistical significance between BA of tacrolimus and the variable factors. In the clinical perspectives, the current converting ratio of tacrolimus in patients with HSCT to be re-considered and an appropriate and optimal alternative regimen should be adopted to prevent GVHD and to increase the quality of life of patients.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.