• Korean Journal of Audiology
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• v.23 no.1
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• pp.53-58
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• 2019

Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

• Quality Improvement in Health Care
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• v.28 no.2
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• pp.14-29
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• 2022

Purpose:In order to improve the quality of cardiac rehabilitation, it is important to examine the experiences of the patients and how they feel about each part of the process. We used a qualitative research methodology to conduct an in-depth review of the experiences of patients who participated in cardiac rehabilitation. Methods: According to semi-structured guidelines, in-depth interviews were conducted with a total of five patients undergoing cardiac rehabilitation. Results: A total of 232 codes was derived; these codes were split into 4 categories and 10 subcategories. Although the patients were apprehensive about the diagnosis of heart disease, it also gave them a chance to reflect on their health behaviors of the past. In addition, they began to appreciate their families and support networks more as the disease progressed. The participants did not know about cardiac rehabilitation until the medical staff recommended it, but they participated in the program with the expectation that they could become healthier. The participants felt that they became more physically and mentally healthy while undergoing cardiac rehabilitation. Rehabilitation served as an opportunity to improve other health behaviors as well. However, they emphasized that it is necessary to continuously maintain improved health behavior, find an exercise method that is suitable for one's physical ability and not monotonous, and prepare a plan to reduce the time and economic burden of cardiac rehabilitation. Conclusion: The participants' positive experiences confirmed in this study will be used as evidence for the expansion of cardiac rehabilitation programs.

• Anxiety and mood
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• v.14 no.2
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• pp.80-87
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• 2018

Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

• Anxiety and mood
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• v.17 no.2
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• pp.49-58
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• 2021

Objective : The purpose of this study was to investigate the longitudinal trajectories of life satisfaction, loneliness, and depression and to identify the factors that influence these trajectories in North Korean Defectors (NKD). Methods : NKD (n=300) who registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea, were recruited into this study. Life satisfaction, loneliness, and depression were assessed with self-report questionnaires over a period of 4 years (7 waves of data). Latent growth modeling was conducted to assess the changes in life satisfaction, loneliness, and depression. Results : Findings from both unconditional and conditional models (with gender, South Korea settlement age, household income, marital status, and PTSD at wave 1) indicated a linear increase in loneliness and depression, and a linear decrease in life satisfaction over the 4-year period. In the conditional model, gender predicted the intercept of life satisfaction and depression. In addition, PTSD predicted the intercept of life satisfaction, loneliness, and depression and slope of depression. Conclusion : Our finding suggests that the mental health of NKD tends to deteriorate over time after settling in South Korea. Therefore, continuous support is necessary for their successful adaptation to the South Korean Society.

• Radiation Oncology Journal
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• v.30 no.4
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• pp.173-181
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• 2012

Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

• Radiation Oncology Journal
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• v.37 no.2
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• pp.110-116
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• 2019

Purpose: This study aimed to identify prognostic factors for locoregional recurrence (LRR) in pT3N0 rectal cancer patients who were treated with surgery alone and had negative resection margin including circumferential resection margin (CRM) for optimal indication of adjuvant radiotherapy. Materials and Methods: We reviewed patients with pT3N0 rectal cancer who were treated via upfront surgery and had no other adjuvant treatment from January 2003 to December 2012. In total, 122 patients who had negative resection margin including negative CRM were included in the analysis. Results: The median follow-up period after surgery was 60 months (range, 3 to 161 months). During this time, 6 patients (4.9%) experienced LRR at the anastomotic site (4 patients), and regional lymphatic area (2 patients). The estimated 5-year rates of overall survival, recurrence-free survival, and LRR-free survival were 96.7%, 84.6%, and 94.0%, respectively. Multivariate analysis showed that level of tumor ≤5 cm was a significant prognostic factor for LRR-free survival (LRRFS) (p = 0.04; hazard ratio = 7.08; 95% confidence interval, 1.06-47.30). Patients with level of tumor ≤5 cm had an estimated 5-year LRRFS of 66.8%, which was much higher than 2.3% in patients with level of tumor >5 cm. There was no significant factor for recurrence-free survival or overall survival. Conclusion: In T3N0 rectal cancer, adjuvant chemoradiotherapy should be recommended in patients with level of tumor ≤5 cm for better local control. However, in patients with pT3N0 disease, negative resection margin, and level of tumor >5 cm, adjuvant chemoradiotherapy should be carefully suggested.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.211-220
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• 1991

Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health Insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women. premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, Proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

• Journal of Korean Society of Archives and Records Management
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• v.23 no.1
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• pp.127-132
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• 2023

The Incheon Medical Center Institutional Review Board (IRB), a department that reflects the characteristics of Incheon Medical Center, a medical and public institution, was established in 2013. IRB contributes to performing its role as a local accountable care hospital and protecting researchers and subjects by proving the ethics of research conducted at the medical center. So far, IRB has reviewed a total of 80 research proposals for human subject research and human-derived material research, and it currently exists as an independent department directly under the president of the medical center. This paper aims to explain the registration and preservation of IRB-related records, the maintenance of the Records Management Standard Table and related regulations, and archives, as well as to present limitations and improvements in the disclosure, utilization, and classification of records.

• Korea Journal of Hospital Management
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• v.12 no.2
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• pp.43-68
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• 2007

The administration of a regional public hospitals are expending from profit preference to publicity preference. The weight rate for a profitability and publicity of performance assessment has changed from 84:16 which was resulted by the assessment executed firstly in 1989 to 39:61 as resulted in 2004, the final assessment execution in 2005. Regional public hospitals are exerting and promoting a magnification in public sector to raise up the public-score. With comparison between publicity scores and profitability scores in original scores basis excluding weight rate, the publicity scores ranked higher than profitability scores although the latter was higher by 2002. However, for the administration performance of the regional public hospitals, the deficits increased 11 times from \92.6billion deficits with \460.3billion cost increased by 457% although income as \367.7billion increased by 394% comparing the last 2004 year to the first 1989 year for profit & loss statement of a regional public hospitals. There was analysis for the relation in yearly basis partitioning publicity and profitability for the assessment scores of the to regional public hospitals confirm the accumulated deficits of the hospitals like this attribute to the extension of public sector. The result showed that there was distinct plus relationship from 1999 although a minus relationship in general until 1997 except 1992 and there is a more plus relationship as approaching 2004. That is, it is hard to tell that the accumulated deficits increase of regional government medical center attributed to extension of public sector. On the contrary, the analysis showed the extension of public sector has a mutual relationship with uplift of profitability Meanwhile, it showed that operation cost rate and labor cost are the factors which influence a revenue & expenditure rate among the profitability index according to the results of relation analysis for the representative index of profitability and that of publicity.

• Health Policy and Management
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• v.26 no.4
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• pp.373-381
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• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.