• 한국간호교육학회지
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• 제21권3호
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• pp.393-405
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• 2015

Purpose: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. Methods: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. Results: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were $37.82{\pm}6.03$. $3.61{\pm}0.38$, $3.61{\pm}0.33$, and $3.73{\pm}0.32$, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. Conclusion: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.

• 대한족부족관절학회지
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• 제17권4호
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• pp.294-301
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• 2013

Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

• 한국비블리아학회지
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• 제32권3호
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• pp.5-21
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• 2021

본 연구는 문헌정보학 전공 분류 수업에서 향후 온라인 매체로만 제공되는 DDC와 관련된 교육을 준비함에 있어 적용할 수 있는 시사점을 파악하고자 하는 목적으로 수행되었다. 이를 위해 DDC의 인쇄본과 웹 버전을 활용한 NCS 기반의 교육과정을 운영한 후, 2차에 걸친 직무능력평가를 통해 매체별 학습성과를 분석하였으며, 매체별 활용 기능, 만족도와 선호도를 분석하기 위한 설문조사를 수행하였다. 분석 결과, 교육 매체의 차이는 학습성과에 통계적으로 유의미한 영향을 미치지 않은 것으로 나타났다. 그러나 학습 시 주로 사용한 매체는 매체에 대한 유용성과 선호도, 그리고 향후 매체 활용도에 영향을 미친다는 것을 확인할 수 있었다. 연구 결과에 기초하여 향후 웹듀이를 활용한 DDC 교육 설계 시, DDC 인쇄본과 비교하여 DDC의 구조와 분류 항목에 대한 이해와 활용을 위한 교육, 웹듀이 인터페이스와 기능에 대한 교육, 전조합 번호에 대한 상대적인 이해와 학습이 필요하다는 점 등을 제안하였다.

• Journal of Chest Surgery
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• 제52권1호
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• pp.25-31
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• 2019

Background: The primary goal of this study was to characterize the clinical outcomes of adult patients with hematologic malignancies (HM) who were treated with extracorporeal membrane oxygenation (ECMO) support when conventional treatments failed. Methods: In this retrospective, observational study at a tertiary medical center, we reviewed the clinical course of 23 consecutive patients with HM requiring ECMO who were admitted to the intensive care unit at Asan Medical Center from March 2010 to April 2015. Results: A total of 23 patients (8 female; median age, 44 years; range, 29-51 years) with HM and severe acute circulatory and/or respiratory failure received ECMO therapy during the study period. Fourteen patients received veno-arterial ECMO, while 9 patients received veno-venous ECMO. The median ECMO duration was 104.7 hours (range, 37.1-221 hours). Nine patients were successfully weaned from ECMO. The in-hospital mortality rate was 91.1% (21 of 23). There were complications in 3 patients (cannulation site bleeding, limb ischemia, and gastrointestinal bleeding). Conclusion: ECMO is a useful treatment for patients with circulatory and/or pulmonary failure. However, in patients with HM, the outcomes of ECMO treatment results were very poor, so it is advisable to carefully decide whether to apply ECMO to these patients.

• 대한치과의사협회지
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• 제57권8호
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• pp.437-447
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• 2019

Purpose: In recent years, efforts to improve the dental curriculum in South Korea have focused on a shift to outcome-based dental education based on core competencies in dentistry. So far, the field has seen various studies on the development of competencies, performance evaluation, and the importance of outcome-based education, but few studies have documented the development of such an education model. Therefore, this study develops an OBE curriculum for dentistry education and describes the development procedures and then finally this study intends to share our experience to other dental schools. Methods: This study introduces the development procedure and details of an outcome-based education model for dental education and presents the five stages of an outcome-based education model. In this study, 3 educational experts and 2 dental professor composed the TFT and developed the research method according to the ADDIE model. Step 1 is to conduct quantitative / qualitative research analysis through some survey and interview, Step 2 is to do a survey to revise competency, Step 3 is to develop a materials through consensus and participation of our professors of the dental school, Step 4 is to do some workshops, Step 5 is to prepare and conduct a outcome evaluation. Results: Step 1 is a required process for developing an educational model: the Job Analysis & Need Analysis stage. Step 2 is the Development of Outcome and Competency stage, which involves revising the competencies that are the basis of the curriculum. Step 3 is developing competency descriptions, competency levels, and evaluation criteria?the Development of Outcomes and Evaluation Standards. Step 4 is the Development of Milestones for Curriculum and Instructional Strategy, which examines the curriculum's problems and analyzes the improvements of each course. Step 5 is the Evaluating Outcomes stage, conducted based on the competencies specified by the target dental school. Conclustion: The model presented here can serve as a foundation for outcome-based education in other dental schools.

• 문화기술의 융합
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• 제5권1호
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• pp.211-217
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• 2019

대학에서의 학기말 프로젝트 작업은 한 학기동안 학습한 내용을 기반으로 학생 스스로 주제 선정, 계획, 결과 도출 과정을 진행해 가는 학습자 중심의 학습 방법이다. 소프트웨어 관련 교과목의 학기말 프로젝트 작업의 경우 해당 프로그래밍 언어에 대한 다양한 기법을 학습 한 후 창의적인 프로그램 개발 과정을 통해 결과물을 완성하게 된다. 그러나 교양과목으로 소프트웨어 교과목을 수강하는 컴퓨터 비전공자는 프로그래밍 언어를 이해하는데 많은 어려움을 느끼고 있기 때문에 학생들이 프로젝트 수행을 원활하게 진행 할 수 있도록 유도하는 교수자의 피드백이 필요하다. 따라서 본 연구에서는 컴퓨터 비전공자의 학기말 프로그래밍 교과목에 대한 프로젝트 수행과정에 적용 할 수 있는 교수자-학습자간의 토론을 통한 피드백 방법을 제안하고, 실제 프로젝트 작업과정에 적용하여 진행과정 및 결과물 분석을 통해 의미 있는 결과를 확인하였다.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.64-70
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• 2022

Background: Anterolateral thigh (ALT) flaps are versatile soft tissue flaps that have become the standard soft-tissue flaps used for head and neck reconstruction. They provide a long vascular pedicle, constant vessel diameter, abundant soft tissue coverage, and minimal donor site morbidity. The ALT flap was initially designed on the basis of a septocutaneous (SC) perforator. However, more recent research has shown that a substantial number of ALT flaps are now based on musculocutaneous (MC) perforators, and the ratio between MC and SC perforators varies among studies. In this study, we analyzed the perforating pattern of ALT flaps along with their clinical outcomes during head and neck reconstruction in the Korean population. Methods: From October 2016 to July 2020, 68 patients who had undergone an ALT flap procedure for head and neck reconstruction were enrolled retrospectively. The perforating pattern of the cutaneous perforator vessel (MC perforator/SC perforator/oblique branch), pedicle length, and flap size were analyzed intraoperatively. Patient demographics and flap necrosis rates were also calculated. Results: The highest number of cutaneous perforator vessels supplying the ALT flap were the MC perforators (87%). The proportion of MC perforators was significantly higher than that of the SC perforators and oblique branches. Flap necrosis occurred in seven cases (11.86%); sex, hypertension, diabetes mellitus, coronary artery disease, perforator course, and history of radiotherapy did not significantly affect flap necrosis. Conclusion: The ALT free flap procedure remains popular for reconstruction of the head and neck. In this study, we observed that the majority of cutaneous vessels supplying the flaps were MC perforators (87%). When using the MC perforator during flap elevation, careful dissection of the perforator is required to achieve successful ALT flaps because intramuscular dissection is difficult. Perforator pattern and history of radiotherapy did not affect flap necrosis.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.685-690
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• 2021

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient's postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.

• Journal of Chest Surgery
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• 제56권1호
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• pp.6-13
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• 2023

Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.117-121
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• 2016

Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.