• 임상이비인후과
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• 제29권2호
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• pp.259-263
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• 2018

There are many treatment options for the malignant melanoma. Wide excisional surgery is one of the most acceptable treatments for locoregional treatment. Depending on the pathologic classification, however, some other treatment option can be included such as chemotherapy, radiotherapy and immunotherapy as adjuvant treatment. Small cell type malignant melanoma is a rare variant of malignant melanoma. It is known that melanomas manifesting this morphology are invariably in vertical growth phase and have an aggressive course. The authors encountered small cell type malignant melanoma and would like to share the experience of successful treatment with surgery plus immunotherapy as one of adjuvant treatment options.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.87-98
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• 2021

Patients with disabilities have difficulties tolerating in-office dental treatment due to limitations relating to cooperation and/or physical problems. Therefore, they often require general anesthesia or sedation to facilitate safe treatment. When deciding on dental treatment under general anesthesia, the plan should be carefully determined because compared to general patients, patients with disabilities are more likely to experience anesthetic complications because of their underlying medical conditions and potential drug interactions. Clinicians prefer simpler and more aggressive dental treatment procedures, such as extraction, since patients with impairment have difficulty maintaining oral hygiene, resulting in a high incidence of recurrent caries or restorative failures. This study aimed to review the available literature and discuss what dentists and anesthesiologists should consider when providing dental treatment to patients with severe disability under general anesthesia.

• 한국환경과학회지
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• 제19권12호
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• pp.1409-1419
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• 2010

Recently, Korea's interest in environment protection is increasingly growing, and Korea realizes the seriousness of environmental pollution and national movement to minimize the effect is arising. As part of the movement, the need of environmental education in elementary schools is on the rise. This study aims to develop integrated environmental experience programs allowing students to have experience activities in forests, rivers, and seas that they can approach easily around them and to have environmental education through various plays. In addition, the study purposes to compare general educational education programs in actual education in terms of the effect of the program on students' environment attitudes. This study was conducted to 50 fourth graders in two classes of S elementary school in Busan, and the 25-student comparative group had the normal educational education program that is mostly being performed in actual education while the 25-student treatment group had the survey on environmental attitude after a class using an integrated environmental experience program. The survey content is about environmental attitudes, and it consists of six subjects such as general environment, environmental pollution, energy, water resources, recycling, and animal protection and has 7 or 8 items by each subject which is divided into eight sub-items including sensibility, belief, values, spontaneity, criticism, patience, attention and interest. The findings are as follows. First, the integrated environmental experience program has a more positive effect on environmental attitudes than the general educational program. In particular, it is really effective about the topic of animal protection among students' environmental attitudes. Second, the integrated environmental experience program has a more positive effect on values and interests than the general environmental education program.

• 보건행정학회지
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• 제9권2호
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• pp.95-117
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• 1999

The purposes of the study was to analysis the factors on the physicians' indemnity experience and indemnity on malpractice. Data was collected from mail interview for the physicians from August, to October in 1996. Questions were asked to the physician who selected with random sample(n=8.338) about the opinion of malpractice insurance. experience that he(she) have requested the indemnity from patience. context of experienced indemnity and demographic characteristics of physician and patience. Response rate is 37.5%(n=3,124). This study was analyzed in two levels' the first. influential factors on whether physician has experience of indemnity and the second. influential factors of indemnity among physicians who had experienced the indemnity. The major findings were as follows : 1. Logistic regression on whether physicians had experience of indemnity request was conducted. And it indicated that statistically meaningful variables of model 1 (about all physicians) were department of surgery, physicians who have intention of insurance fee, physician age and income, physicians who owned the hospitals and statistically meaningful variables of model 11 (about physicians who owned the hospital) were department of surgery and internal treatment. 2. Multiple regression on the influential factors on indemnity was conducted. And it showed that statistically meaningful variables in model 1 were method of malpractice quarrel(physician association), whether physician had malpractice, whether suit succeeded, physician age, average practice time and income and whether physician owned the hospital and statistically meaningful variables of model 11 were whether physician had malpractice, number of outpatient, number of beds. As the conclusion, the thesis was examined about the variables related with experience of indemnity and cost of malpractice. But in order to prevent malpractice and promote medical quality, the reasonable system to solve a malpractice have to settle and cost estimation on malpractice is essential. Therefore an advanced research is progressed with methodology to decide the indemnity bases.

• 한국치위생학회지
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• 제10권6호
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• pp.965-972
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• 2010

Objectives : This study was conducted to improve oral heath behaviour of child by analyzing child's mother oral health behaviour. Methods : A total of 361(95.0%) 3-year-old-child's mothers who sent their child to child care institution in Daegu were analyzed from October 1, 2009 to October 31, 2009. Results : 1. In relation to general nature and experience on oral health education of child's mother, mother with higher monthly income, over than graduation from university and professional job had high oral health education experience, which was statistically related(p<0.01)(p<0.001). 2. In the case of mother with oral health education experience, this mother had higher dental clinic visit for 1 year, higher experience on scaling, higher good food preference for teeth health and higher use of floss, which was statistically related(p<0.05)(p<0.01). 3. Regarding child's oral management behaviour by mother's oral health importance, in the case that oral health was important, flouride toothpaste use, restriction on cavity inducting food and toothbrushing before sleep were higher only, which was statistically related(p<0.05)(p<0.001). Conclusion : In case of mother with oral health education experience, this mother had experience on dental clinic visit for prevention of cavity, dental clinic visit for treatment and restriction on food in which their child's oral health behaviour were satisfactory, which was statistically related.

• 의료커뮤니케이션
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• 제13권2호
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• pp.159-166
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• 2018

Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

• 한국치위생학회지
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• 제8권3호
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• pp.161-175
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• 2008

With the change of medical environment, people are taking interest not just in treatment but in the prevention of oral diseases. As people's interest in oral diseases increases, the number of dental institutions is increasing continuously and this is heightening the necessity and importance of professional dental hygienists equipped with expert knowledge of oral health. Thus the present study purposed to survey and analyze the current state and weight of works carried out by dental hygienists, and to propose dental hygienists' works desirable in the medical environment changing its focus from treatment to prevention. The results of this study are as follows; 1. In the results of dividing dental hygienists' works into oral examination and preliminary examination, preventive works, assistance to dental treatment, oral health education, hospital administration and management, and surveying the performance rate of these works, the work of the highest performance rate in preliminary examination was collection of patients' systemic history (87.6%). It was also scaling (96.9%) in preventive dental treatment, preparation for treatment (96.5%) in assistance to dental treatment, education on the toothbrushing method (92.3%) in oral health education, and tool disinfection and management (72.2%) in hospital administration and management. 2. When the performance rate was surveyed according to age, institution, and work experience, the performance rate by work area was highest in dental hygienists aged between 27~28, those working at a dental clinic, and those with 4~6 years' work experience. 3. The weight of dental hygienists' works was high in order of assistance to dental treatment (59.1%), observation of oral health condition and preliminary examination (12.4%), oral health education (12.4%), hospital administration and management (10.4%), and preventive dental treatment (5.8%), but in the results of surveying perception on the importance of works, the importance was high in order of oral health education (34.7%), preventive dental treatment (29.0%), observation of oral health condition and preliminary examination (19.3%), assistance to dental treatment (11.2%), and hospital administration and management (5.8%), showing that the weight of works carried out current was different from perception on the weight of works regarded as important. 4. To the question on parts to be developed in response to the change of medical environment, the most frequent answers were the establishment of their roles as preventive dental practitioners (75.7%), and the establishment of their roles as oral health educators (74.9%). This was consistent with the works that dental hygienists gave the highest weight to, and suggested that dental hygienists regarded preventive dental treatment as most important. Development of abilities to give counsel to patients was 55.2%, acquisition of theoretical knowledge of dental treatment 42.1%, improvement in quality as a hospital manager 28.2%, and acquisition of skills to assist dental treatment 23.2%. These show that, even with regard to the development of future oriented dental hygienists' capacities, assistance to dental treatment was perceived less important as it was with regard to the importance of work.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7167-7170
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• 2015

Background: Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. Objective: To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. Materials and Methods: This is a prospective institutional study in Southern India carried on from $1^{st}$ June 2012 to $31^{st}$ July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. Results: The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. Conclusions: In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

• Journal of Preventive Medicine and Public Health
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• 제32권2호
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• pp.215-227
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• 1999

Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.12-18
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• 2015

Objective : Covered stent has been recently reported as an effective alternative treatment for direct carotid cavernous fistulas (DCCFs). The purpose of this study is to describe our experiences with the treatment of DCCF with covered stents and to evaluate whether a covered stent has a potential to be used as the first choice in selected cases. Methods : From February 2009 through July 2013, 10 patients underwent covered stent placement for a DCCF occlusion. Clinical and angiographic data were retrospectively reviewed. Results : Covered stent placement was performed for five patients primarily as the first choice and in the other five as an alternative option. Access and deployment of a covered stent was successful in all patients (100%) and total occlusion of the fistula was achieved in nine (90%). Complete occlusion immediately after the procedure was obtained in five patients (50%). Endoleak persisted in five patients and the fistulae were found to be completely occluded by one month control angiography in four. The other patient underwent additional coil embolization by a transvenous approach. Balloon inflation-related arterial dissection during the procedure was noted in two cases; healing was noted at follow-up angiography. One patient suffered an asymptomatic internal carotid artery occlusion noted seven months post-treatment. Conclusion : Although endoleak is currently a common roadblock, our experience demonstrates that a covered stent has the potential to be used as the first choice in DCCF; this potential is likely to increase as experience with this device accumulates and the materials continue to improve.