• Journal of Korean Academic Society of Home Health Care Nursing
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• v.12 no.1
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.401-406
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• 2016

Background: Cholangiocarcinoma is relatively rare worldwide. Most previous reports collected only patients with pathological diagnosis. In fact, however, many patients coming to hospital are diagnosed by clinical suspicion with radiologic imaging and receive treatment without histological confirmation. Real survival data and outcome of each treatment, especially for patients that do not have histologic confirmation, are lacking. In this study, therefore, we aimed to analyze the survival rates of CCA patients and the proportions of patients receiving different treatments. Materials and Methods: A total of 270 patients clinically suspected of CCA and visiting Srinagarind Hospital in May-July 2010, were prospectively followed until December 2014. After checking their clinical records, 163 of 270 patients were finally diagnosed as having CCA, and the data of this group were analyzed for survival rate and received treatments. Results: Of the 163 patients, 96 (58.9%) had intrahepatic, 56 (34.4%) had perihilar and 11 (6.7%) had distal CCA. The majority [107 (65.6%, 95%CI, 57.8-73.0)] received only supportive care. Overall median survival was 4 months (95%CI, 3.3-4.7), and 2-years survival was only 8.1% (95%CI,4.5-12.9). However, the 4 year survival of the R0 resection group was 100%. Conclusions: The present results show that the prognosis of CCA is very poor in North-east Thailand. Most CCA patients receive only treatment to alleviate symptoms due to their advanced stage of disease. Complete surgical resection at the early stage is the only treatment that significantly improves patient survival.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.72-78
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• 2011

Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.193-198
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• 2015

Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.148-153
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• 2011

Background: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. Materials and Methods: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. Results: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. Conclusion: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.

• Korea Journal of Hospital Management
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• v.20 no.3
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• pp.13-23
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• 2015

This research is intended to inquire any discrepancy depending on the variables such as types, geography and size of hospitals of Korea in order to develop differentiated marketing strategy and to investigate how the aforementioned variables affect the management performance such as the increase in the number of foreign patients, their willingness to re-visit, the increase in profit and etc. The survey for this research was conducted for five weeks from July 10th 2014 to August 30th 2014 with 251 participants in charge of foreign patient attraction for 161 domestic hospitals. As the method of the research, a hypothesis was first established based on previous studies, followed by the incorporation of self-administered questionnaire to confirm the formulated hypothesis. Frequency analysis and ANOVA analysis were used to analyze the result of the survey. The outcome of the research and the implications are as follows. First, according to the demography of the persons-in-charge of foreign patient attraction, the proportion of female was superbly high by 76.5%. As for the age, those in their 30s were highest in proportion. Finally, for the education level, college graduates took up the largest portion by 46.5%. Second, in respect to the hypothesis assuming the difference in performance depending on the types of hospitals, national university-affiliated hospitals showed the highest level of the increase in foreign patients by the average of 3.25. Third, in respect to the hypothesis assuming the difference in performance based on geographical position, it was confirmed that hospitals in Ulsan City experienced the largest growth in the number in foreign patients. Fourth, in respect to the sizes of hospitals, those with 201 to 300 sickbeds showed the highest increase by the average of 3.45. The implication of the above research outcome indicates that while the number of foreign patients visiting Korea for medical purposes is on the rise, the number of professionals in place with necessary knowledge and capacity is insufficient and requires improvement.

• Korean Journal of Acupuncture
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• v.25 no.4
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• pp.205-217
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• 2008

Background : One of the characteristics of acupuncture, a popular modality for treating musculoskeletal pain, is a plurality in diagnosis and treatment that can profoundly influence the treatment outcome. This multiplicity in treatment modality has to be considered in any research on the effectiveness of acupuncture. Many practitioners stress the necessity for individualized patient treatment, including acupuncture point selection and manipulation technique. However, the importance of individualization in acupuncture treatment, compared with standardization, has received little attention in clinical trials. The aim of the future study described here is therefore to compare the effectiveness of individualized acupuncture for knee osteoarthritis with standardized acupuncture and no acupuncture in patients with knee osteoarthritis. Methods : A total of 195 patients aged 50 years and over with knee pain, will be randomly divided into three treatment groups: individualized acupuncture, standardized acupuncture, and waiting list. Outcome data will be collected through patient.completed questionnaires before randomization, and at 4, 8 and 12 weeks after randomization. The questionnaires will be investigated demographic details as well as information on pain, movement and function of the affected knee, general health and quality of life. Discussion : This paper presents details on the rationale, design, and methods of the trial.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.51-57
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• 2011

Background: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. Material and Methods: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. Results: Mean age at operation was $66.0{\pm}12.4$ years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of $28.0{\pm}17.8$ months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (${\geq}$95%), or in small solid lesions (${\leq}$2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of $31.7{\pm}11.6$ months, no patient developed recurrence. Conclusion: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.

• Asian Spine Journal
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• v.12 no.6
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.2
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• pp.236-250
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• 2019

Objectives: The purpose of this study was to investigate the effect of intensive rehabilitation programs on pain, range of motion (ROM), lumbar muscle strength, core muscle endurance, disability, and depression in patients with traumatic low back injuries and to compare the efficacy of this therapy with that of conventional rehabilitation therapy. Methods: The study was performed with a retrospective medical chart review of patients with traumatic low back injury referred to the rehabilitation center at the Daegu Hospital of the Korean Workers Compensation and Welfare Service. Forty-four patients were allocated to either the conventional rehabilitation group (CRG; n = 22) or the intensive rehabilitation group (IRG; n = 22). The CRG group patients, who received 30-min therapist-supervised physical therapy and modality therapy five times per week for four weeks, were compared with the IRG group patients, who received 60-min therapist-supervised physical therapy, 30-min therapist-patient 1:1 matching rehabilitation therapy, and modality therapy five times per week for four weeks. Outcome measures were a numerical rating scale, ROM, lumbar muscle strength, lumbar core muscle endurance, thickness of lumbar deep focal core muscle (transverse abdominis and lumbar multifidus), Oswestry disability index (ODI), and depression (Korean version patient health questionnaire-9). Results: There were statistically significant improvements after treatment in all outcome measures in both groups (p < 0.05). In the intergroup comparison, NRS scores on the activity and thickness of lumbar deep focal core muscles increased significantly more in the IRG than in the CRG (p < 0.05). There were no statistically significant intergroup differences in NRS scores on resting, ROM except left lateral bending, lumbar muscle strength, core muscle endurance, ODI, and depression. Conclusions: We could confirm the superior effectiveness of an intensive rehabilitation program compared to conventional rehabilitation therapy in patients with traumatic low back injuries.