• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9687-9692
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• 2014

Background: Biliary tract cancers are rare, and surgical resection is the standard treatment at early stages. However, reports on the benefits of adjuvant treatment following surgical resection are conflicting. This study aimed to evaluate the factors affecting survival and adjuvant treatments in patients with surgically treated biliary tract cancers. Materials and Methods: Patient clinical features, adjuvant treatments, and efficacy and prognostic factor data were evaluated. Survival analyses were performed using SPSS 15.0. Results: The median overall survival was 30.7 months (95% confidence interval [CI], 18.4-42.9 months). Median survival was 19 months (95% CI, 6-33) for patients treated with fluorouracil based chemotherapy and 53 months (95% CI, 33.2-78.8) with gemcitabine based chemotherapy(p=0.033). On univariate analysis, poor prognostic factors for survival were galbladder localization, perineural invasion, hepatic invasion, a lack of adjuvant chemoradiotherapy treatment, and a lack of lymph node dissection. On multivariate analysis, perineural invasion was a poor prognostic factor (p=0.008). Conclusions: Biliary tract cancers generally have poor prognoses. The main factors affecting survival are tumour localization, perineural invasion, hepatic invasion, adjuvant chemoradiotherapy, and lymph node dissection. Gemcitabine-based adjuvant chemotherapy is more effective than 5-fluorouracil-based chemotherapy.

• Archives of Plastic Surgery
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• v.40 no.2
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• pp.104-108
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• 2013

Background Microsurgical techniques are considered standard procedures in reconstructive surgery. Although microsurgery by itself is defined as surgery aided by optical magnification, there are no guidelines for determining in which clinical situations a microscope or loupe should be used. Therefore, we conducted standardized experiments to objectively assess the impact of optical magnification in microsurgery. Methods Sixteen participants of microsurgical training courses had to complete 2 sets of experiments. Each set had to be performed with an unaided eye, surgical loupes, and a regular operating microscope. The first set of experiments included coaptation of a chicken femoral nerve, and the second set consisted of anastomosing porcine coronary arteries. Evaluation of the sutured nerves and vessels were performed by 2 experienced microsurgeons using an operating microscope. Results The 16 participants of the study completed all of the experiments. The nerve coaptation and vascular anastomoses exercises showed a direct relationship of error frequency and lower optical magnification, meaning that the highest number of microsurgical errors occurred with the unaided eye. For nerve coaptation, there was a strong relationship (P<0.05) between the number of mistakes and magnification, and this relationship was very strong (P<0.01) for vascular anastomoses. Conclusions We were able to prove that microsurgical success is directly related to optical magnification. The human eye's ability to discriminate potentially important anatomical structures is limited, which might be detrimental for clinical results. Although not legally mandatory, surgeries such as reparative surgery after hand trauma should be conducted with magnifying devices for achieving optimal patient outcomes.

• Archives of Plastic Surgery
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• v.45 no.2
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• pp.140-145
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• 2018

Background Cranially-based nasolabial flaps are a good alternative for the reconstruction of nasal defects. Methods A cranially-based nasolabial flap was used in 18 patients to reconstruct defects of the nose from 2010 to 2016, and the long-term results are presented in this report. Results Fifteen of the flaps completely survived. All the patients had a bulky appearance, but they did not want to undergo a second operation for cosmesis. The dissection of the flap took approximately 20 minutes, and the total operation lasted for 1 hour. The patients were hospitalized for 1-7 days, and the postoperative follow-up period was 1-28 months (mean, 17 months). Conclusions The cranially-based nasolabial flap possesses all the advantages of the traditional forehead flap, and can safely be used in selected cases.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• Journal of Korean Clinical Health Science
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• v.1 no.1
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• pp.91-98
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• 2013

Purpose: The purpose is to study the effects of the vision training, as a non-surgically treated vision therapy, on the objective and the subjective symptoms of the patients with intermittent exotropia combined with vertical deviation. Method: For the boys at the age of eight with intermittent exotropia, who report a long-distance blurred vision, dazzling, and intermittent diplopia more than ten times a day, the vision training had been practiced for seven weeks. The objective and subjective symptoms have been examined after six months from the end of the training. Results: The objective and the subjective symptoms have been improved after the seven weeks training and the improvements lasted after six months from the end of the treatment. Conclusion: Non-surgical treatment for the patients with intermittent exotropia, including intermittent exotropia combined with vertical deviation like this case, should be considered as an auxiliary treatment and on the preferential basis.

• International Journal of Advanced Culture Technology
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• v.9 no.4
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• pp.169-179
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• 2021

This study was conducted to develop and apply clinical nursing practice training simulation program using Standardized Patient for Nursing Students focused on infectious respiratory disease. This study is descriptive methodological study. Through prior consideration of documents and educational task of infectious respiratory disease was conducted with interview of clinical specialists of infection control managers. Development of educational task for infectious respiratory disease for Nursing Students went through the content validity. Finally, 10 educational tasks are developed 'knowledge of respiratory infections disease', 'hand washing', 'put on mask', 'lead to put on mask to patients and caregiver', 'intravenous injection via 3way', 'surgical aseptic technique', 'sterilization medical instrument', 'management of contaminated linen', 'infected personnel management manual'. The infectious respiratory disease simulation program was developed based on the ADDIE model and proceeded to 4 steps of analysis, design, development, implementation. The infection control education program included lectures (20 min), skill training (20 min), simulation using standardized patient (20 min), and debriefing (40 min), The collected data were analyzed by descriptive statistics with SPSS program for version 23.0. The results of this study confirmed that the clinical nursing practice training simulation program using standardized patients was effective in infectious respiratory disease of the nursing college students in knowledge of infectious respiratory disease and clinical nursing performance. we found this practical training program for nursing college students to improve knowledge and clinical competency of infection control. we expected that this developed program could be applied to practical training for various infectious control.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2012.05a
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• pp.761-762
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• 2012

• Journal of Internet Computing and Services
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• v.20 no.4
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• pp.47-53
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• 2019

In general, dizziness is caused by various situations, but among them, symptoms due to dysfunction of the motor system belonging to the nervous system are the most severe, accompanied by nausea and vomiting. Treatment of these dizziness includes drug therapy, surgical therapy, and rehabilitation. Drug therapy and surgery are generally performed in vest rehabilitation training, which is a rehabilitation therapy because of the risk of aftereffects. The vestibular rehabilitation training includes eye training, posture stabilization training, and walking training. Among them, walking training is performed in a certain space under the supervision of a doctor or a professional therapist, so that the time and space burden is increased. In order to solve this problem, we implemented gait training contents which can be used for rehabilitation training by using the augmented reality technology. It is expected that it can be utilized as dizziness rehabilitative contents which can be used in medical environment through clinical tests for patients with dizziness.

• Korean Journal of Adult Nursing
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• v.28 no.5
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• pp.546-558
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• 2016

Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.76-81
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• 2018

Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.