• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.25-32
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• 2008

Purpose: The purpose of this study was to examine quality of life with patients in 12 months after coronary artery bypass graft surgery, compared with general population. Method: A cross-sectional comparative study was designed. Study participants were 90 adults who had undergone CABG surgery (n=45) in experimental group and general population (n=45) in control group. The subjects were asked the questionnaire (SF-36, Short Form-36) regarding the quality of life. The data were analyzed by the SPSS 13.0 program including frequency, percentage, $x^2$ test, t-test and One-Way ANOVA. Results: There were no significant differences in the quality of life between two groups including physical functioning (t=-.938, p=.351), role-physical limitation (t=-.322, p=.748), bodily pain (t=-.938, p=.351), general health (t=-.1418, p=.888), vitality (t=-.816, p=.417), social functioning (t=.720, p=.474), role-emotional limitation (t=-.710, p=.479), mental health (t=-.431, p=.667). Conclusion: Even though patients in experimental group had operation experience, the quality of life examined on the time of 1 year after bypass surgery is similar in that of general population. We suggest the study change the design as examination of quality of life before and after coronary artery bypass graft surgery.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.490-493
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• 2011

Purpose: Basosquamous carcinoma is a rare malignancy, with features of both basal cell carcinoma and squamous cell carcinoma. It is considered as aggressive tumor with a high risk of recurrence and metastases. Authors report a case of basosquamous cell carcinoma. Methods: A 72 year-old man, who had an erythematous ulcer on his left auricle, described a slow growing lesion, starting at the posterior surface of the superior helix with a steady increase in size during the past 10 years. At operation, auricular cartilage was grossly invaded by the tumor and was, therefore, amputated with tumor-free margins. Results: Histopathologic examination was revealed a basosquamous cell carcinoma. On positron emission tomography/computed tomography (PET/CT) and neck CT were negative for signs of further nodal involvement or metastases to other organs. At follow-up 6 months later, his wounds were noted to be well healed, with no evidence of local recurrence or identifiable metastases. Conclusion: Because basosquamous cell carcinoma has a significant potential to recur and metastasize, surgical excision for this type of carcinoma should be more extensive than that performed for conventional basal cell carcinoma or squamous cell carcinoma. In addition, regional lymph nodes should be monitored and close follow-up should be carried out.

• Korean Journal of Artificial Intelligence
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• v.10 no.2
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• pp.13-18
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• 2022

The role of artificial medical intelligence through medical big data has been focused on data-based medical device business and medical service technology development in the field of diagnostic examination of the patient's current condition, clinical decision support, and patient monitoring and management. Recently, with the 4th Industrial Revolution, the medical field changed the medical treatment paradigm from the method of treatment based on the knowledge and experience of doctors in the past to the form of receiving the help of high-precision medical intelligence based on medical data. In addition, due to the spread of non-face-to-face treatment due to the COVID-19 pandemic, it is expected that the era of telemedicine, in which patients will be treated by doctors at home rather than hospitals, will soon come. It can be said that artificial medical intelligence plays a big role at the center of this paradigm shift in prevention-centered treatment rather than treatment. Based on big data, this paper analyzes the current status of artificial intelligence technology for chronic disease patients, market trends, and domestic and foreign company trends to predict the expected effect and future development direction of artificial intelligence technology for chronic disease patients. In addition, it is intended to present the necessity of developing digital therapeutics that can provide various medical services to chronically ill patients and serve as medical support to clinicians.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.299-305
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• 2015

Objectives: This article describes our experience with neck dissection in 10 patients with oral squamous cell carcinoma. Materials and Methods: Between January 2007 and October 2009, 10 patients underwent primary surgery for the treatment of squamous cell carcinoma of the oral cavity. For patients with $N_0$ disease on clinical exam, selective neck dissection (SND [I-III]) was performed. In patients with palpable cervical metastases (N+), modified radical neck dissections were performed, except in one patient in whom SND (I-III) was performed. The histopathologic reports were reviewed to assess the surgical margins, the presence of extra-capsular spread, perineural invasion, and lymphatic invasion. Results: On histopathologic examination, positive soft tissue margins were found in three patients, and regional lymph node metastases were present in five of the ten patients. Perineural invasion was noted in five patients, and extra nodal spread was found in four patients. Regional recurrence was seen in two patients and loco-regional recurrence plus distant metastasis to the tibia was observed in one patient. During the study period, three patients died. Seven patients remain free of disease to date. Conclusion: Histopathological evaluation provides important and reliable information for disease staging, treatment planning, and prognosis. The philosophy of neck dissection is evolving rapidly with regard to the selectivity with which at-risk lymph node groups are removed. The sample size in the present study is small, thus, caution should be employed when interpreting these results.

• Journal of Korean Clinical Nursing Research
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• v.18 no.1
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• pp.86-98
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• 2012

Purpose: The present study was conducted with the aim of developing a training manual for operation room nurses through an examination of nursing actions in terms of the frequency of performance, importance, and the levels of difficulty. The participants were recruited from the five university-affiliated hospitals according to one's career ladders, resulting in getting 181 OR nurses enrolled. Methods: Researchers developed a questionnaire using a 5-point Likert scale which measuring OR nurses' actions, importance, and the levels of difficulty. The frequencies of performance, importance and the levels of difficulty of nursing action were compared according to their career ladders using one-way ANOVA. Results: The frequencies of performance showed significant differences in 26 items according to the participants' career ladders; the importance in 6 items; and the levels of difficulty in 19 items among the OR nurses' actions. Conclusion: Given the fact that the significant differences were shown in the frequencies of performance, importance, and the levels of difficulty in nursing action across differing work experience, continuous development and application of job training based on one's work experience seem crucial in practice.

• Korean Medical Education Review
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• v.21 no.2
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• pp.92-99
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• 2019

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.79-88
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• 2005

Quality assurance may be defined as the complete set of systemic actions that is required to achieve a better treatment result by standardizing treatment and by using various audit programs. In general, application of a quality assurance program in surgery is considered to be more difficult than it is in chemotherapy or radiotherapy. However, recently, the importance of quality assurance in the surgical field has been emphasized in clinical trials comparing different surgical procedures and evaluating the role of postoperative adjuvant therapy. In the case of gastric cancer surgery, excellent quality assurance programs have rarely been applied in most large prospective clinical trials. Although the quality assurance in Dutch trial was conducted very systemically and strictly, the situation is quite different from ours. On the other hand, several quality assurance programs in Japanese trials comparing D2 and D2 plus para-arotic lymph node dissection seem to be applicable to Korean clinical trials. Several factors, including selection of appropriate surgeons based on personal experience and annual number of operations, standardization of surgical procedures by education and consensus, development of a unified database program, application of standardized perioperative management, and standardization of pathologic examination, are required to guarantee a successful multi-institutional prospective clinical trial. In contrast, one needs to realize that protocols that are too strict and sophisticated can make the enrollment of patients and surgeons more difficult and can promote protocol violation during the clinical trials. (J Korean Gastric Cancer Assoc 2005;5:79-88)

• Journal of Korean Academy of Nursing
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• v.6 no.2
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• pp.32-38
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• 1976

The advanced knowledge is increasing day by day due to the progress of medicine and tectonics, the increase of nursing research nowadays. In parallel with these, nursing profession has a need of the nursing care with improvement of new Knowledge, tectonics and nursing procedure through the insertive education. Therefore, this study was attempted to investigate that to grasp learning need of nurses about inservice educational play a pivotal role in the progress of inservice education. This study was made from 242 clinical nurse at 4 hospitals in Seoul and through question- are consisting of 1) ideological part 2) basic sciences 3) nursing part 4) administrative part 5) the others from 10 July '75 to 7 Oct. '75. The data were treated by percentage, Licker method, arid chi- square examination. Significant difference p is 0.05. The results of this studies are as follows : A. learning needs of nurses 1) Generally the learning needs of nurses is very high. 2) Of the learning need of inservice education for nurses, the highest learning need is as follow (Table 2 ) 1 st : Charting 2 nd : The ability of grasping patient's needs and problems. 3 rd ; The contents and the methods of the advanced nursing skill. 4 th ; The importance of team work 5 th ; The general knowledge of the various disease 6 th : The decision of a propriety nursing diagnosis under the general condition. 7 th ; The introduction of the new nursing theory. 8 th : The Nurses role and the responsibility in emergency and disaster. 9 th : The improvement of nursing skill for the perfect interpersonal relationship. l0th ; Cultural education: B . Verification of hypothesis 1. Hypothesis I , learning needs of nurses and educational level of nurse will be correlated, is rejected (Table 3 ) 2. Hypothesis II, learning need of nurses and duties of post will be correlated, is rejected (Table 4) 3. Hypothesis III, learning need of nurse and clinical experience of nurses will be correlated, is rejected (Table 5).

• Korean Journal of Clinical Pharmacy
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• v.27 no.1
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• pp.44-54
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• 2017

Background: Mental health issues such as stress and depression have been regarded as major social problems in Korea. We investigated the relationship between stress and depression with unmet medical needs (UMN). Methods: Using the nationwide database of 2010 Korea National Health and Nutritional Examination Survey (K-NHANES), subjects aged 19 years or above were selected (n=6,055). In the K-NHANES questionnaire, subjects were asked about their UMN experience, severity of stress, and perceived depression lasting at least 2 weeks over the past year. The effects of stress and depression on UMN were analyzed in 4 models established by adding predisposing, enabling and need factors in a step-wise fashion. The risks for UMN were also assessed according to the causes of UMN. Results: Individuals who felt stress 'very often' (odds ratio (OR) 3.28, 95% CI=2.23-4.86) and 'often' (OR 2.53, 95% CI=1.93-3.31) and who experienced depression (OR 1.68, 95% CI=1.35-2.10) reported significantly elevated UMN rates, and these effects were substantial especially for the individuals who had UMN due to economic constraint. Females, lower education level, lower income, unemployed status, and negative perceptions about health status were found to be additional risk factors for UMN. Conclusion: Our results confirmed the risks of stress and depression on UMN. It is strongly advisable to create initiatives to improve mental health, particularly stress and depression, and to fulfill individuals' medical utilization needs.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.615-618
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• 2008

Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.