• Advances in pediatric surgery
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• 제18권2호
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• pp.59-67
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• 2012

Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p= 0.032). Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p= 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

• 대한치과의사협회지
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• 제53권2호
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• pp.111-119
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• 2015

The importance of effective communication is increasingly stressed in the medical sector. This is crucial for the resolution of medical accidents and conflicts, and that can contribute to the prevention of the two as well. The careful attitude of the medical team toward patient safety and their communication with colleagues and other departments are mandatory for the successful decrease of dental accidents. The good communication within of the hospital organization is one of vital ways to ensure accurate diagnosis and successful treatment. In the field of health care, effective teamwork requires a shared goal, superb work skills, communication and cooperation, but this fact has been overlooked so far. Among those factors, communication is indispensable to the achievement of organizational goals, and how to boost communication by acquiring diverse skills and using appropriate tools in the dentistry should discreetly be considered. This study explared how to improve the teamwork and communication of organization in an effort to seek specific ways of reducing medical conflict in dental.

• 품질경영학회지
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• 제41권4호
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• pp.527-539
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• 2013

Purpose: Methods for increasing health-care service quality are considered for a women-centered hospital located on a local city. A walk-through audit is applied to uncover areas for improvement. Methods: A survey questionnaire with 25 questions is constructed based on a service blueprint for a walk-through audit, and a survey is conducted both to patients and service providers to assess a health-care service quality. Frequency analysis, statistical tests and customer-provider analysis are used to analyze surveyed data. Results: According to customer-provider analysis, 6 attributes belong to 'problem unawareness' zone in which they are rated high by service providers but low by patients, and another 6 attributes belong to 'problem awareness' zone in which they are rated low by both groups. These attributes are considered to be improved with priority. Conclusion: Both patient group and service provider group have lots of different perceptions on most attributes that are examined, and the hospital to be studied is, in general, competitive in technical quality and less competitive in functional quality.

• 한국의료질향상학회지
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• 제19권2호
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• pp.50-64
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• 2013

Objectives : Suicide is a serious sentinel event in healthcare organization. Suicide and suicidal attempt are fatal and long lasting mental and physical damage to themselves, family, and medical staffs. To develope the system to prevent suicidal accident in hospital, we reviewed and analysed one case of suicidal sentinel event. Methods: The risks of suicidal sentinel event were evaluated and analysed through the root cause analysis and failure mode effects analysis. Result: We found several root causes such as initial assessment of oldest patient and security issues. Couple of action plans to fix the problems were done immediately. According to failure mode, we evaluate the risk priority number to modify the action plans. Conclusion: To reduce the risk of sentinel events, we reviewed the suicidal event and established the new system and action plan to prevent sentinel events.

• 한국병원경영학회지
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• 제17권4호
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• pp.133-166
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• 2012

Hospitals tend to provide uniformed service to patients despite their various demands stemming from the severity of disease stages or the uncertainties in information of treatment stages. To identify service factors and provide effective contextually aware service models that patients demand depending on their evolving circumstances, the study conducted a survey on service quality based on importance and satisfaction of cancer patients. The study surveyed 286 patients and caregivers on importance and satisfaction through a questionnaire comprising of 17 questions at the outpatient clinic of cancer centers of university hospitals in 5 cities. Based on the risks of the disease and uncertainties in information of treatment stages, the cancer patients were grouped into diagnosis stage; low-risk treatment stage; high-risk treatment stage; stabilization stage. Depending on the patient's situation, the importance and satisfaction of service factors were ranked. These factors were categorized into 4 groups from a managerial perspective into 'keep it up area', 'focus here area', 'low priority area', 'overdone area'. This study provides an effective medical service model that can accommodate patients based on management areas of cancer patients.

• 한국응급구조학회지
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• 제17권2호
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• pp.9-20
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• 2013

Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

• Toxicological Research
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• 제23권3호
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• pp.197-205
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• 2007

Cancer metastasis is a major determinant of cancer patient mortality. Mounting evidence favors a strong positive role for $TGF-{\beta}$ in human cancer progression. The complex pattern on cross-talk of $TGF-{\beta}$ and the related other signaling pathways is an important area of investigation that will ultimately contribute to understanding of the bifunctional role of $TGF-{\beta}$ in cancer progression. This review summarizes some of the current understanding of $TGF-{\beta}$ signaling with a major focus in its contribution to the tumor cell invasion and metastasis. Five issues are addressed in this review: (1) $TGF-{\beta}$ signaling, (2) $TGF-{\beta}$ and EMT, (3) $TGF-{\beta}$ and MMP, (4) $TGF-{\beta}$ and Ras, and (5) Role of $TGF-{\beta}$ in invasion and metastasis. Due to the bifunctional cellular effects of $TGF-{\beta}$, as a tumor promoter and a tumor suppressor, more precisely defined $TGF-{\beta}$ signaling pathways need to be elucidated. According to the current literature, $TGF-{\beta}$ is clearly a major factor stimulating tumor progression through a complex spectrum of the interplay and cross-talk between various signaling molecules. Understanding the role of $TGF-{\beta}$ in invasion and metastasis will provide valuable information on establishing strategies to manipulate $TGF-{\beta}$ signaling which should be a high priority for the development of anti-metastatic therapeutics.

• 산업경영시스템학회지
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• 제35권4호
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• pp.33-40
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• 2012

Dentists are known to be highly exposed to the musculoskeletal disorders (MSD). The present study investigated the prevalence of MSD among Korean dentists and association between their MSD and physical workload. In addition, detailed causes related to the physical workloads were identified in dental operation, and needs for improvement of dental instrument and environment were collected from Korean dentists. The standardized Nordic questionnaire was used to survey body troubles and three types of questionnaires were made to investigate the physical workloads, causes of the physical workloads and improvement priority of dental equipments, respectively. A total of 104 Korean dentists were participated in the survey. Neck trouble (82%) was the most prevalent in Korean dentists, and shoulder (68%) and low back trouble (56%) followed, while low back trouble was reported to be most frequent in previous studies. The body troubles were related to the physical workload of the corresponding body parts, although they were not associated with personal characteristics. Most Korean dentists selected 'to keep direct view inside patient's mouth' and 'no support of the hand with dental instruments' as the causes of awkward and strenuous work postures. They wanted design improvement for some equipment in their operating room such as operating light and arrangement of workplace.

• 호스피스학술지
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• 제7권2호
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• pp.26-41
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• 2007

There are three things that are not known to the human being. That is when, where and how one will die. Most people live ignoring death. However, elements of death linger everywhere. The purpose of this treatise is investigates about justification Deciding for Other directions. First, I will investigate about Deciding for Other directions, when patient can not decide own, I will do investigate agent's decision's problem. Second, These four principles provide the common ground for biomedical ethics. Principlism argue that a method using four principles can resolve controversies in bioethics. The method holds that there are four principles-respect for autonomy, nonamleficence, beneficence, justice- that articulate the necessary conditions of common morality for health care and bioethics. Beauchamp and Childress respond by arguing that the two problems are nc the meaning or interpretation but the process of specification. Third, So, Supplement four principles' problem to Levinas concept of the Other theory. Levinas concept of the Other is very resemblant with 'Love your neighbour as yourself." Christians believe that Love is above all and they act accordingly. They base this faith mainly upon the motto of "love your neighbour as yourself." Fourth. difficult part of Levinas concept of the Other is that there is no human to equal infinite sense of responsibility. Can be supplemented about this through cooperation of community. Four principles can be brought to bear on moral choices. And they asserts that each principles has weigh but they do not assign a priority weighting of ranking. All the principles are equal in moral decision making.

• 한국병원경영학회지
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• 제20권2호
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• pp.39-56
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• 2015

This study calculated the potential customer satisfaction improvement index (PCSI index) and average satisfaction coefficient (ASC) by categorizing quality attributes based on the Kano analysis for medical service quality. This study seeks to suggest ways to increase the efficiency of medical business management by determining priority to improve after applying the indexes to IPA. To achieve such purposes, this study conducted a survey on 150 outpatients of a premium general hospital and 200 workers in four different sections in the same hospital. As a result of the analysis, there was a difference in the awareness of service quality to improve patient satisfaction between the outpatients and workers. Therefore, the focus should be put on those items deemed important by the patients rather than those that the workers called attention to in order to effectively improve service quality. Along with efforts to alleviate or eliminate inconveniences experienced by patients, it is necessary to provide training programs for workers on customer reception and management such as delivering services with a kind manner and giving explanations in a proper and professional manner and exhibiting the right attitude.