• Quality Improvement in Health Care
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• v.4 no.1
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• pp.36-49
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• 1997

Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

• Advances in pediatric surgery
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• v.15 no.2
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• pp.121-131
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• 2009

Intestinal malrotation presents with different clinical characteristics, depending upon the age of the patient. The medical records of 44 patients treated for intestinal malrotation with/without midgut volvuls between January 2002 and August 2009 at Seoul National University Children's Hospital were reviewed retrospectively. Patients were grouped by the age criteria of 1 and 12 months. Fourteen patients were under 1 month of age (31.8 %), 9 patients between 1 month and 12 months (20.5 %) and 21 patients over 12 months (47.7 %). Twenty patients (45.5 %) presented with volvulus. Vomiting (66 %) and abdominal pain (20 %) were the most common symptoms. UGIS (68.2 %) was the most frequent diagnostic tool. Mean postoperative hospital stay was 13.7 days. There were 7 mild postoperative complications. Volvulus was more frequent in patients under 1 month (p=0.025) than over 1 month. The interval between diagnosis and operation was shorter in patients under 1 month (p=0.003) than in patients over one month of age. In the age between under and over 12 months, volvulus was more common in those under 12 months of age, but the difference was not significant. The interval from diagnosis to operation was shorter in patients under 12 months than over 12 months of age (p=0.001). Vomiting was the most frequent symptom in patients under 12 months. On the other hand, abdominal pain was the most frequent symptom in patients over 12 months. In conclusion, patients with intestinal malrotation had age-related differences in the presence of midgut volvulus, the interval between diagnosis and operation, and clinical symptoms. The age of the patient should be considered in order to determine adequate treatment of malrotation.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.518-521
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• 2012

Background Skin cancer is the most common malignant tumor in humans. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common types of skin cancers. When skin cancer is clinically suspected, preoperative biopsies are recommended for a definite diagnosis. However, despite a concern over potential increased risk of metastasis associated with mechanical manipulation, there have been few investigations into whether a preoperative biopsy affected the recurrence of BCC and SCC. Methods Primary BCC or SCC patients who underwent standard surgical excision from 1991 to 2010 were reviewed and a retrospective analysis was performed. Ultimately, 45 BCC patients and 54 SCC patients, who did not meet the exclusion criteria, were analyzed. To identify whether a preoperative biopsy affected the recurrence of BCC and SCC, the recurrence rates of each with and without biopsy were compared. Results Preoperative biopsy had no statistically significant effect on recurrence (BCC, P=0.8680; SCC, P=0.7520). Also, there was no statistical significance between the interval from initial biopsy to first operation and recurrence (BCC, P=0.2329; SCC, P=0.7140). Even though there was no statistical significance, the mean interval from the biopsy to the operation among the BCC patients who underwent preoperative biopsy was 9.2 months in those who had recurrence and 2.0 months in those who had no recurrence. Conclusions There was no statistically significant relationship between preoperative biopsy and recurrence of BCC and SCC. However, there was a tendency toward recurrence in patients with a longer interval between the biopsy and the corrective operation in BCC.

• Journal of Sleep Medicine
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• v.15 no.2
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• pp.68-73
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• 2018

Objectives: Periodic leg movements in sleep (PLMS) are associated with arousals and autonomic activation, which may contribute to higher cardiovascular disease risk in patients with restless legs syndrome (RLS). Non-periodic leg movements in sleep (NPLM) are leg jerks in sleep that does not satisfy standard criteria of PLMS. The aim of this study was to evaluate impact of short-interval leg movements in sleep (SILMS) and isolated leg movements in sleep (ILMS) in comparison to PLMS on heart rate in both patients with RLS and healthy controls. Methods: Seven idiopathic RLS patients and 9 controls were enrolled in this study. Polysomnographic studies were analyzed and leg movements (LM) were automatically detected. NPLM can be classified as SILMS and ILMS. SILMS are LM separated by an inter-movement interval (IMI) shorter than 10 s, and ILMS are LM with IMI longer than 90 s. Frequency and heart rate associated with SILMS, ILMS, and PLMS in RLS patients were compared to those in controls. Heart rate change associated with LM were determined for a fixed time window. Results: Frequencies of SILMS and ILMS of patients with RLS were not significantly different to those of controls. RLS patients presented higher heart rate change associated with SILMS than PLMS before movement onset, while heart rate change associated with SILMS, ILMS, and PLMS were not different in the controls. Conclusions: Although the number of SILMS is not higher than PLMS, SILMS may have closely associated with higher cardiac activation of RLS than PLMS. Therefore, SILMS might be an important treatment target for patients with RLS to reduce long-term cardiovascular risk. Long-term prospective studies are needed to evaluate the relationship between NPLM and cardiovascular disease in patients with RLS.

• Journal of the Ergonomics Society of Korea
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• v.20 no.1
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• pp.15-29
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• 2001

This study was conducted to develop a prototype of adjustable desk and chair for students from elementary to high school. The development process started with identifying the problems of existing adjustable desks and chairs that are currently available in the market. The following fundamental design criteria were established and then applied to develop the prototype. The criterion of minimization of production cost yielding lower the market selling price was the most critically considered in view of the school furniture buyers' price-consciousness. Other design criteria used in this development were designing for stable and solid structure, requiring few motions and no tools to adjust, requiring the use of only one hand to adjust, unrestricting the adjustable interval, providing extra space for foot and knee area, reducing weight to move easily, and requiring not to move around for cleaning up floor. To evaluate the performance of the prototype, the adjustability of prototype was specifically compared with both dimensions suggested by KS G 2010(Korean Standards for desks and chairs for students) and current anthropometric dimension in terms of the flexible range of accommodation. Results of this study illustrate that the prototype developed in this study could be accommodated for the both dimensions. As a concluding mark, appropriate adjustable range for various grades and age groups were presented.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.110-118
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• 2010

Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

• Fashion & Textile Research Journal
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• v.14 no.2
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• pp.269-276
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• 2012

The aim of this study is to develop clothing size system according to each size interval for obese girls aged 10~12 by classifying the upper bodies. The criteria for subjects in this study were girls who had over 1.46 of the R$\ddot{o}$hrer Index. A total of 229 schoolgirls who met these criteria were enrolled. Results are as follows; 1st, 5 factors were extracted by factor analysis and 3 clusters were categorized by cluster analysis, cylinder-type, inverted triangle-type and inverted trapezoid-type. And 2nd, as a consequence of size system establishment, the basic body sizes and reference body sizes were different according to types even in commonly-appeared size names at sections of respective types. The research findings above suggest that it is necessary to figure out the obesity types according to height and bust girth sizes representing basic sizes and to design the patterns in consideration of the characteristics of obese body shapes. And it may be used as a basic data to decide the desirable output of production according to respective body types.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.373-374
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• 2006

This study is carried out to analyze the stability of a container crane in according to the change of a wind direction and a machinery house location when a wind load of a wind velocity, 75m/s was applied on the state stowing a container crane by a heavy wind. A design wind load applied to this study was calculated in observance of 'Load Criteria of Building Structure'. And we analyzed the reactions of each supporting points according to appling a wind direction to an interval of $10^{\circ}\;in\;0^{\circ}{\sim}180^{\circ}$ and the structure stability of a container crane according to changing a machinery house. location occupying 15% of a container crane weight. From a results of this study, we presented a design criteria of an overturning disturbance equipment, tie-down.

• Archives of Pharmacal Research
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• v.13 no.2
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• pp.180-186
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• 1990

A bioequivalence study of ranitidine tablets was conducted according to the Korean Guidine for the Bioequivalence Test using twelve healthy male subjects. The plasma concentration-timecurves of ranitidine from the test and reference tablets showed profound multiple peak phenomenon in each subject as reported earlier. However, the area under the plasma concentration-time curve (AUC) and the maximum ploasma concentration at the first peak ($C_{max1}$) of the two preparations was proven to be equal when analyzed satistically according to the criteria of the guidline;i. e., statistical power (1-$\beta$)was calculated to be over 0.8 under the condition of $\alpha$ = 5% and $\Delta$(minimum detectable difference) = 20%, and the confidence interval of the difference in AUC at 95% confidence level was in the range of $\pm$ 20%, which statisfied the criteria of bioequivalence. Equivalence of the peak concentration of ranitidine at the second peak ($C_{max2}$), and the time to reach the first ($T_{max1}$) and second verify the bioequivalence of $c_{max2}$ , $T_{max1}$ and $T_{max2}$ between the two tablets. However, we conclude that the test and reference tablets are bioequivalent taking the therapeutic characteristics of the ranitidine preparations into consideration.

• Archives of Pharmacal Research
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• v.18 no.4
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• pp.237-242
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• 1995

For the vioequivalence study of two ceftriaxone injection formulations ($Rocephin{\circledR}$ ; Roche, and Triaxone ; Hanmi0, the HPLC analytical method for the analysis of ceftriaxone in plasma was used. Fourteen healthy volunteers completed the study and each subject were IM in jected signle doses (1 g) of the test and the reference formulations in a two-way crossover design with an one week drug free interval between doses. Following each administration, plasma concentrations of ceftrixone were monitored over a period of 24 h. Bioequivalence parameters $AUC_{24th}, {\;}T_{max}, {\;}C_{max}$ and MRT determined from the data obtained for the two formulations were examined by analyses of variance (ANOVA) and other criteria and tests for bioequivalence. Results of ANOVA and confidence limits of test/reference ratios of $AUC_{24th}, {\;}T_{max}, {\;}C_{max}$ and MRT, and statistical tests indicated the bioequivalence of the two formulations (i.e., test/reference ratio was within $100{\pm}20%$) except for $T_{max}$ The mean of $T_{max}$ showed only 6. 9% difference from the reference but the detection limit was 22.5% which is slightly over the 20% criteria. No pharmacokinetic parameters including Ka, Kel, Vd and Cl indicated significant difference in between the two fomulations. It was concluded that the data yielded fro the two cefriaxone formulations demonstrated that they were bioequivalent.