• Journal of Advanced Navigation Technology
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• v.14 no.4
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• pp.504-511
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• 2010

The personal bio-information supplied from the PHD(Personal Health Device) for personal health management is very sensitive in relation to a personal living body in an aspect of privacy protection. On the assumption thai the information is about a patient, it is more serious problem if it is revealed to a third party. However. the established ISO (International Organizations for Standardization) standard protocol[1] in October 2009 has just considered a transmission part for mutual exchange of bio-information between individuals, but has never actually considered security elements. Accordingly, this paper is to show all sorts of security threats according to personal health management in the u-health environment and security requirements newly.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.1-9
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• 2010

Although ultrasonography is the most commonly used first-line imaging modality of the female pelvis because of diagnostic accuracy, low cost and safety, MRI is the best imaging modality of choice for the evaluation of the female pelvis. The indication of female pelvis MRI is diverse and includes the evaluation of M$\ddot{u}$llerian duct anomaly, differential diagnosis and characterization of uterine and ovarian tumors, and staging of malignant uterine and ovarian tumors. Understanding of MR protocols according to the specific gynecologic pathology allows accurate diagnosis and proper patient management.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.111-119
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• 2017

Objectives Clinical pathway (CP), is management plans that display goals for patients and have led to improve outcomes for many diseases. In Korea, Interest in Korean medicine's stabilization (Clinical pathway, Clinical Practice Guideline) is increasing, But the number of studies is scare. Method and Analysis This trials composes nonequivalent control group pretest-posttest design to conduct clincal pathway trial for the acute pain after back surgery. The subjects were 10 control patients with back surgery, and 10 experimental patients with application of integrative CP. Each group patient will observed 6 weeks. We check validation of CP. Also we compared the patient's status using the pain, function, Quality of life index between the two groups. Discussion This trial is the first CP for the acute pain after back surgery using integrative medicine concepts. Aim of this trial is to find the effectiveness and validity of clincal pathway for acute pain after back surgery.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.96-108
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• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.12-31
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• 2015

Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.99-108
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• 2023

Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome. Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann-Whitney U-test. Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m² (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p < .001, p = .008). The APHCHE IV was also higher in the NRHG (p < .001). RH occurred 25.49 (7.28-52.96) hours after TTM completion, lasting for 2 (1-3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p = .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.404-409
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• 2021

Background To date, there are no consensus guidelines for management of lymphatic leak in groin vascular reconstruction patients. The goal of this study is to review the relevant literature to determine alternatives for treatment and to design an evidence-based algorithm to minimize cost and morbidity and maximize efficacy. Methods A systematic review of the literature was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Two independent reviewers applied agreed-upon inclusion and exclusion criteria to eligible records. Studies that included patients who underwent groin dissection for oncologic diagnoses and level 5 data were excluded. Interventions were then categorized by efficacy using predetermined criteria. Results Our search yielded 333 records, of which eight studies were included. In four studies, the success of lymphatic ligation ranged from 75% to 100%, with average days to resolution ranging from 0 to 9. Conservative management in the form of elevation, compression, and bedrest may prolong time to resolution of lymphatic leak (14-24 days) and therefore cost. Conclusions The majority of patients should be offered early operative intervention in the form of lymphatic ligation with or without a primary muscle flap. If the patient is not an operative candidate, a trial of conservative management should be attempted before other nonsurgical interventions.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.441-446
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• 2005

Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• The korean journal of orthodontics
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• v.49 no.5
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• pp.338-346
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• 2019

In this report, we describe the successful use of alternate rapid maxillary expansions and constrictions with a hybrid hyrax-mandibular miniplate combination and simultaneous orthodontic treatment for the management of severe Class III malocclusion due to maxillary hypoplasia in an 11-year-old girl. The devices were removed after 20 months of treatment, and the family was instructed about a careful control and retention program that should be followed in accordance with the patient's growth. The final result included the correction of Class III malocclusion with adequate function and excellent facial esthetics, which restored the patient's self-esteem and provided personal motivation. The outcomes showed good stability after 24 months of retention. The decrease in the duration of active treatment is the most important finding from the present case. Considering that facial esthetics in adolescence is a determining factor for the development of a personality and interpersonal relationships, we recommend the use of this protocol for growing patients, who will exhibit not only an improved physical appearance but also a better quality of life.