• Journal of Korean Academy of Nursing
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• v.22 no.1
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• pp.49-67
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• 1992

Most hospitalized children will experience physical pain as well as psychological distress. Preschool children's pain perception related to painful procedures can increase due to elevated anxiety and fear because they do not have understanding logical of their disease and hospitalization. In particular, they are distressed about needle - related procedures which are feared because they are seen to be a cause of bodily damage. This descriptive study attempted to identify pain perception levels in preschool children and their mothers. A self-reporting measurement and behavioral observation were used to collect the data. A total of 25 hospitalized preschool children and their mothers were investigated and data were collected about 60 painful procedures. Data collection was carried out by the researcher and two trained investigators from November first to December tenth. Three insruments were used to collect the data : Faces Pain Rating Scale(FPRS) developed by Beyer was used to measure the degree of preschool children's pain perception about painful procedures. The Visual Analogue Scale(VAS) devised by Huskisson was used to assess the degree of mothers' pain perception about their children's painful procedures. A Pain Behavioral Checklist based on the Procedure Behavior Check List by LeBaron and Zelter and modified by the researcher was used to observe behaviors of preschool children, their mothers, and nurses when the painful procedures took place. The data were analyzed by an SPSS program, and were tested using real numbers, percentages, Pearson correlation coefficient, t-test, and ANOVA. The results of this study are as follows : 1. Of all the painful procedures, the mean score for the FPRS for the preschool children's pain perception was 4.02 points, and the mean score for the VAS of mothers' pain perception was 10.92 points. 2. A Positive correlation which was statistically significant was found between the pain perception of preschool children and their mothers (r＝.53, p＜.01). that is, the higher the children's pain perception was, the higher their mothers' pain perception was. 3. The characteristics of the painful procedures related with children's pain perception as follows : The type of painful procedure was found to be statistically significant (F＝23.44, p＜.01), Among the three procedures Ⅳ starting was found to be perceived as the most painful procedures to the children. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝4.44, p＜.01), and the longer the duration of the procedure, the higher the pain perception wa(r＝.30, p＜.05). Pain perception in the treatment room was higher than in the children's room(t＝6.30, ＜.01), pain perception in the mother's presence was the higher than when the mother was not present (t＝2.91, p＜.01). 4. The characteristics of the painful procedures related with the mothers' pain perception as follows : The type of painful procedure was found to be statistically significant(F＝6.01, p＜.01). Among the three procedures Ⅳ sampling was found to be perceived as the most painful procedures to the mothers. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝5.95, p＜.01), and the longer the duration of the procedure, the higher the pain perception was (r＝.31, p＜.05). Pain perception in the treatment room was higher than in the children's room (t＝3.51, p＜.01), but pain perception in the mother's presence showed statistically significant no difference. 5. Of all of the 19 children's behaviors during the painful procedures, the most frequent behaviors observed Were as follows in order of frequency “crying”, “screamirig”, “facial grimacing”, “physical resistance”, Of all of the nine methers' behaviors, the most frequent by observed in “console children”, “hold children”, “applaud children”, Of all of the 11 nurses' behaviors during the painful procedures, the mast frequent in order were “smiling”, “physical restraint”, “console children”, “praise children”. 6. A positive correlation between children's and mothers' pain perception and children's behaviors was found to be statistically significant (r＝.65, p＜.01, r＝67, p＜.01). Also the relationship between children's and mothers' pain percertion, and mothers' behavior was found to be statistically significant (r＝.57, p＜. 01, 4＝.60, p＜.01). The relationship between children's pain perception and nurses' behaviors was also found to be statistically significant (r＝.46, p＜.01), but there was difference between mothers' pain perception and nurses' behaviors.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.575-584
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• 1997

The quality of periodontal instrument cutting edge is a basic element of effective root planing procedure. Using instruments, the sharp edge is changed into blunt or beveled edge. With the blunt instrument, the periodontal treatment can't be carried into accuracy and effective. The study on the wear of periodontal curet is insufficient, there are few publications about the change of sharpness of cutting egde after using instrument and a certen reports were published on the study of scanning electron microscope(SEM) examination. In this study, to declare the number of strokes for sharpening of instruments, the changes of cutting edge is measured by the clinical methods, tactile sensitivity examination and refraction light-white line test after scaling strokes and root planing strokes. SEM test was added for defined the changes of cutting edges. The 7/8 Gracey curets that have been never used was tested. Maxillary molars which were extracted from the School of Dental Medicine, Dankook University was used. Subjected teeth had attachment loss more than 6 mm in bucca-lingual surface and sufficient calculus of a band type in cervical area. The strokes of curet were executed 3, 5, 7, 9, 11, 13 times on scaling stroke and 10, 15, 20, 25, 30, 35 times on root planing stroke. A resident has periodontal experience over 3 years carried out the clinical examinations those tactile sensitivity examination and refraction light-white line test 5 times. The case there being tactile sensitivity certenly is 2, the case being felt tactile sensitivity is 1, and the case there not being tactile sensitivity is 0. The visual examination was recorded as following. The case that refracted white line is not recognised is 2, the case that uncerten is 1, and the case that acknowledged is 0. The results were obtained as follows. 1. After scaling strokes, the tactile sensitivity was reduced after 11 strokes and disappeared in 13 strokes. 2. In tactile sensitivity after root planing procedures, sensitivity was reduced after 25 strokes and disappeared in 35 strokes. 3. In case of visual examination, the detection of refracted white line was increased after 9 strokes of scaling procedures and the accuracy of wear wasn't showed after root planing procedures. 4. In SEM, metal projection was observed on new periodontal curet cutting edge and it was disappeared after scaling procedures. 5. In SEM, the cutting edge was showed changing linear into an aspect of the surface after 5 strokes of scaling procedures and 10 strokes of root planing procedures and showed beveled edge in 11 strokes of scaling procedures, 25 strokes of root planing procedures. The results of 3-type examination indicated that the sharpening of curet should be performed after 11 strokes of scaling procedures and 25 strokes of root planing procedures.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.234-239
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• 2008

Objective : There are a few reports on the complications of surgery for epilepsy. We surveyed our data to present complications of epilepsy surgeries from the neurosurgeon's point of view and compare our results with other previous reports. Methods : A total of 179 surgical procedures for intractable epilepsy (41 diagnostic, 138 therapeutic) were performed in 92 consecutive patients (10 adults, 82 children) during the last 9.2 years (February. 1997-April. 2006). Their medical records and radiological findings were reviewed to identify and analyze the surgical complications. Results : The diagnostic procedures encompassed various combinations of subdural grid, subdural strips, and depth electrodes. Four minor transient complications developed in 41 diagnostic procedures (4/41=9.8%). A total of 138 therapeutic procedures included 28 anterior temporal lobectomies, 21 other lobectomies, 6 lesionectomies, 21 topectomies, 13 callosotomies, 20 vagus nerve stimulations, 13 multiple subpial transections, and 16 hemispherectomies. Twenty-six complications developed in therapeutic procedures (26/138=18.8%). Out of the 26 complications, 21 complications were transient and reversible (minor; 21/138=15.2%), and 5 were serious complications (major; 5/138=3.6%). Five major complications were one visual field defect, two mortality cases and two vegetative states. There were 2 additional mortality cases which were not related to the surgery itself. Conclusion : Our results indicate that complication rate was higher than previous other reports in minor complications and was comparable in major complications. However, our results show relatively high frequency of mortality cases and severe morbidity case compared to other previous reports. The authors would like to emphasize the importance of acute postoperative care in young pediatric patients as well as meticulous surgical techniques to reduce morbidity and mortality in epilepsy surgery.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.520-528
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• 2014

Background As the breast cancer incidence has increased, breast-conserving surgery has replaced total mastectomy as the predominant procedure. However, centrally located breast cancers pose significant challenges to successful breast-conserving surgeries. Therefore, we performed partial mastectomy and oncoplastic procedures on centrally located breast cancer as a means of partial breast reconstruction. The authors examined and evaluated the functional and aesthetic usefulness of this reconstruction method. Methods From January 2007 to June 2011, 35 patients with centrally located breast cancers who underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques such as purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic procedures included volume replacement procedures with an adipofascial, thoracoepigastric, intercostal artery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results Mean patient age was 49 years, and mean follow-up period was 11 months. In cases of small to moderate-sized breasts and resection volumes <50 g, volume displacement procedures were performed. In cases of resection volumes >50 g, volume replacement procedures were performed. In cases of larger breasts and smaller resection volumes, glandular reshaping was performed. Finally, in cases of larger breasts and larger resection volumes, reduction mammaplasty was performed. This reconstruction method also elicits a high patient satisfaction rate with no significant complications. Conclusions In centrally located breast cancer, oncoplastic surgery considering breast size and resection volume is safe and provides appropriate aesthetic outcomes. Therefore, our method is advisable for breast cancer patients who elect to conserve their breasts and retain a natural breast shape.

• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.239-244
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• 2009

Objective : Cerebral vasospasm leading to cerebral ischemic infarction is a major cause of morbidity and mortality in the patients who suffer with aneurysmal subarachnoid hemorrhage. Despite adequate treatment, some patients deteriorate and they develop symptomatic vasospasm. The objective of the present study was to investigate the efficacy and clinical outcome of intraarterial nimodipine infusion on symptomatic vasospasm that is refractory to hemodynamic therapy. Methods : We retrospectively reviewed the procedure reports, the clinical charts and the transcranial doppler, computed tomography and digital subtraction angiography results for the patients who underwent endovascular treatment for symptomatic cerebral vasospasm due to aneurysmal SAH. During the 36 months between Jan. 2005 and Dec. 2007, 19 patients were identified who had undergone a total of 53 procedures. We assessed the difference in the arterial vessel diameter, the blood flow velocity and the clinical outcome before and after these procedures. Results : Vascular dilatation was observed in 42 of 53 procedures. The velocities of the affected vessels before and after procedures were available in 33 of 53 procedures. Twenty-nine procedures exhibited a mean decrease of 84.1 cm/s. We observed clinical improvement and an improved level of consciousness with an improved GCS score after 23 procedures. Conclusion : Based on our results, the use of intraarterial nimodipine is effective and safe in selected cases of vasospasm following aneurysmal SAH. Prospective, randomized studies are needed to confirm these results.

• Journal of Korea Society of Industrial Information Systems
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• v.13 no.2
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• pp.88-99
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• 2008

In this article, DHRMIS being developed with ERP at resent realizes the personnel affairs recording procedures that all the Ministry of National Defense, the army, the navy and the air force can use on personnel affairs in order to solve the problem of the personnel recording procedures of the MND and each of the troops such as using manual affairs together with computation affairs, absence of electronic recording managements in some of the institutions MND, insufficiency of real time recording, and excess of centralized managements to present and record the personnel data. The personnel recording procedures consist of standardized personnel recording procedures and definition of the personnel recording procedures. This personnel recording procedures propose 3 improvements such as an atomic electronic recording management, a real time recording affair, effective centralization and distribution of verification authority so as to guarantee authentication, integrity, reliance, and accessibility of personnel data. When proposed personnel recording procedures are realized through developing DHRMS, these can bring on unification of 10 recording management systems, reduction of recording management time from 45 days to 3 days, distribution of verification authority MND, each of the troops, each of the institutes, an individual, and reduction of some of the manual documents.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.47-53
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• 2017

Objectives : The Korean Resource Based Relative Value Scale (K-RBRVS) was introduced in 2001 as an alternative of the previous medical fee schedule. Unfortunately, most neurosurgeons are unfamiliar with the details of the K-RBRVS and how it affects the reimbursement rates for the surgical procedures we perform. We summarize the K-RBRVS in brief, and discuss on how the relative value (RV) of the spinal neurosurgical procedures have changed since the introduction in 2001. Methods : We analyzed the change of spinal procedure RVs since 2001, and compared it with the change of values in the brain neurosurgical procedures. RVs of 88 neurospinal procedures on the list of K-RBRVS were analyzed, while 24 procedures added during annual revisions were excluded. Results : During the past 15 years, RVs for spinal procedures have increased 62.8%, which is not so different with the cumulative increase of consumer prices during this time period or the increase rate of 92.3% for brain surgeries. When comparing the change of RVs in more complex procedures between spinal and brain neurosurgery, the increase rate was 125.3% and 133%, respectively. Conclusion : More effort of the society of spinal surgeons seems to be needed to get adequate reimbursement, as there have been some discrimination compared to brain surgeons in the increase of RVs. And considering the relative underestimation of spinal neurosurgeons' labor, more objective measures of neurospinal surgeons' work and productivity should be developed for impartial reimbursement.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.660-669
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• 2021

Background The demand for aesthetic procedures continues to grow globally, particularly in East Asian countries. The popularity of specific aesthetic procedures varies, however, depending on the particular East Asian geographical region being studied. This study aimed to evaluate the experiences of and attitudes toward aesthetic procedures in five East Asian countries/regions, including China, Japan, South Korea, Hong Kong, and Taiwan. Methods To recruit participants, an online questionnaire was designed and distributed on social media networks between May 2015 and March 2016. The statistical analysis was conducted using SPSS software, version 22.0. Results A total of 3,088 people responded (approximately 600 in each country/region). Of these, 940 participants (47.8%) responded that they had experienced at least one aesthetic procedure in the past. Taiwan had the highest number of participants who had experienced at least one procedure (264/940, 41%), with primarily non-surgical experiences. Only in South Korea did surgical cosmetic experiences exceed non-surgical cosmetic experiences (55.9% vs. 44.1%). The popularity of particular procedures and the motivation for undergoing aesthetic procedures varied by country. Conclusions The popularity of aesthetic procedures continues to evolve. Similar trends were observed across the East Asian regions; however, each country had its unique demands and preferences. The information provided by this study can help aesthetic plastic surgeons further understand the patients in their corresponding region, customize their practice, and develop the requisite skills.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.21-29
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• 2023

Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.