• Archives of Craniofacial Surgery
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• v.21 no.4
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• pp.237-243
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• 2020

Background: The scalp is an important functional and aesthetic structure that protects the cranial bone. Due to its inelastic characteristics, soft-tissue defects of the scalp make reconstruction surgery difficult. This study aims to provide an improved scalp reconstruction decision making algorithm for surgeons. Methods: This study examined patients who underwent scalp reconstruction within the last 10 years. The study evaluated several factors that surgeons use to select a given reconstruction method such as etiology, defect location, size, depth, and complications. An algorithmic approach was then suggested based on an analysis of these factors. Results: Ninety-four patients were selected in total and 98 cases, including revision surgery, were performed for scalp reconstruction. Scalp reconstruction was performed by primary closure (36.73%), skin graft (27.55%), local flap (17.34%), pedicled regional flap (15.30%), and free flap (3.06%). The ratio of primary closure to more complex procedure on loose scalps (51.11%) was significantly higher than on tight scalps (24.52%) (p=0.011). The choice of scalp reconstruction method was affected significantly by the defect size (R=0.479, p<0.001) and depth (p<0.001). There were five major complications which were three cases of flap necrosis and two cases of skin necrosis. Hematoma was the most common of the 29 minor complications reported, followed by skin necrosis. Conclusion: There are multiple factors affecting the choice of scalp reconstruction method. We suggest an algorithm based on 10 years of experience that will help surgeons establish successful surgical management for their patients.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.144-154
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• 2007

Purpose: This descriptive study was conducted to identify the use of complementary and alternative therapies, and the perception and attitudes toward CAT in Korean adults. Methods: The 1,010 study subjects were recruited from ten regions in South Korea. Data were collected from July to September, 2004. Results: The 43.2% of the sample(n=436) had an experience of using CAT. The subjects using CAT was more likely to have high score in the CAT perception compared to the subjects with no experience of CAT(p=.001). The primary source of information about CAT was mass media(59.7%). The 52.4% of the sample answered that CAT was supplementary and the 27.7% answered CAT was applicable to chronic pain or musculoskeletal disorders. Subjects(34.8%) pointed out that the greatest problem was no scientific informant in the use of CAT. The primary reason of using CAT was to maintain their health or to prevent disease(44.0%), and the 59.0% of the subjects responded that CAT was effective. Majority of subjects were satisfied with CAT(63.3%) and experienced no side effects of CAT(90.6%). Conclusion: This study suggests that professional counseling and education for CAT is needed for Korean public as well as the research approach to test the effects of CAT.

• Korean Journal of Social Welfare
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• v.65 no.3
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• pp.155-182
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• 2013

The purpose of this study is to examine how the long-term care effects the elderly that adapt themselves to the caring facility, what their experiences are and what kinds of behavioral characteristics they present. We have analyzed the research conducted on 15 elderly individuals who are living in an elderly long-term care facility, by using the grounded theory approach of Strauss and Corbin (1998). As a result, 170 concepts, 42 sub-categories, and 15 categories were set by the open coding process. During the adaptation process in a long-term care facility, the primary experience or feeling by the elderly is that they had been 'deserted'. However, when consolidating the casual conditions, contextual conditions, intervening conditions, the action/interaction strategy, and consequence, the primary experience was that the elderly came to an 'acceptance'. Such acceptance was then sub-categorized into a destiny-resignation type, reality-acceptance type, and voluntary-selection type. Based on the results of this study, we recommend practical alternatives which will improve surrounding circumstances including caring facilities, its employees, relationships with other elderly individuals, and family support.

• Journal of Korean society of Dental Hygiene
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• v.7 no.3
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• pp.231-245
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• 2007

This study aims to discuss plans to improve the satisfaction level of dental services by understanding characters of beliefs about dental manpower and analyzing its related factors. Data were collected by structured questionnaire whose subjects consist of 1607 persons from 13 years old to 69 years old, who have ever experienced dental institution. Both univariate and biovariate analyses were employed to analyze level of dentist and dental hygienist's beliefs and its related factors and the results gained from the surveys and search are as follows. 1. Among the questions to measure dentist's beliefs, 'Respect for patients' was evaluated as the best, and the lowest items were 'not-hopeful explanation about prognosis of dental treatment', 'satisfactory explanation' and 'whether treatments are stopped by pains or not'. In addition, among questions to measure dental hygienist's beliefs, 'kindly welcome' and 'detailed explanations about medical directions' are the items evaluated as the best and 'notice of waiting time' marked the lowest evaluation. 2. The factors related to beliefs about dentists were age, ache experiences, dental fear, self-reported dental health status, frequence and primary purposes of the visits dental institutions, elapsed time from recently visited, present of favorite dental clinic to visit regularly. 3. The factors related to beliefs about dental hygienists were age, education, occupation, ache experiences, frequence and primary purposes of the visits dental institutions, periodic check of teeth, present of favorite dental clinic to visit regularly. 4. Direct painful, painful treatment experience under insufficient local anesthetic, indirect painful experience and dental fear were positively correlated. And the relationships were positive between ache experiences, dental fear and self-reported dental health status, but relationships were negative between ache experiences, dental fear and dentist! dental hygienist's beliefs.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.99-106
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• 2005

Neuroblastoma treatment remains challenging, but treatment has become more effective due to the establishment of clinical and biological variables that determine prognostic risks. Initially, stage and age were the prime determinants of survival used in clinical practice. Risk-based therapy currently is the hallmark of neuroblastoma treatment. This study reviews one center's experience with the management of neuroblastoma. Sixty-three patients with neuroblastoma were treated from 1989 to 2003. All patients were graded according to the International Neuroblastoma Staging System (INSS) at diagnosis. There were 37 boys and 26 girls. The median age was 2.14 years (range, 33 days-10.2years). The primary site was the adrenal gland in 47, dumbbell shape extending into spinal canal in 6, retroperitoneum in 5, mediastinum in 3, and other sites in 2. The probability of 5-year overall survival (OS) and event free survival (EFS) were 46.7 % and 44.2 % by Kaplan-Meier method. According to INSS, there were stage 1 in 2 cases, stage 2 in 5, stage 3 in 12, stage 4 in 42, and stage 4s in 2. There were statistically significant differences in the survival rates between patients with stage1, 2 and stage 3, 4(P<0.05). For the stage 3 and 4, the extents of surgical resection, determined from the operative records and pathologies, were complete resection in 17 cases, minimal residual in 15, and partial resection 11, and the 5-year OS rate was 57.8, 51.4, and 13.6 %, respectively. There is a trend toward higher OS with more complete resection (P<0.05). We conclude that age and stage at diagnosis are prognostic factors, and complete excision of the primary tumor can provide better prognosis for patients with stage 3 and 4 neuroblastoma.

• The Journal of Korean Medicine
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• v.45 no.1
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• pp.257-270
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• 2024

Objectives: Korea has a unique history of being both a recipient and a donor of Official Development Assistance (ODA), and the international community expects Korea to contribute to the development of developing countries by utilizing this experience. Traditional Korean medicine (TKM) seeks to contribute to global health, however the concept of ODA has been unclear and there has been no clear strategy and sustainable initiatives. Methods: This study examines the concept of ODA and its application in global health, including business objectives, scale, evaluation principles, and development strategies. Additionally, we reviewed the current status of Traditional Korean medicine globalization projects and conducted a SWOT analysis of the internal and external environment of the TKM sector. Based on these findings, we redefined the concept of ODA for TKM and proposed suggestions for its development. Results: The current study identified key ideas for TKM ODA. It should prioritize the improvement of primary healthcare in recipient countries, aligning with the international evaluation criteria of the SDGs. Secondly, TKM's 70 years of experience can be leveraged to enhance both the competence and economic benefits of recipient countries' medical systems. Based on these concepts, a TKM ODA development model was proposed, comprising two core visions, three development strategies and goals, and six core values. Conclusion: This study systematically examined the TKM in global health and suggested sustainable development strategies for TKM ODA. Through its expansion, TKM could contribute to the advancement of global traditional medicine and its overall engagement in healthcare.

• Journal of Korean Academy of Rural Health Nursing
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• v.18 no.2
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• pp.80-91
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• 2023

Purpose: The purpose of the study quantitatively investigates the experience of unmet healthcare service utilization by rural populations in vulnerable areas during the COVID-19 pandemic based on Andersen's behavior model. At the same time, this study attempts to describe the experiences of unmet healthcare service utilization among participants in vulnerable rural areas by analyzing qualitative contents through open-ended question. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. A total of 863 participants completed an online survey. Quantitative data were analyzed using 𝑥² test and logistic regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting participants' unmet healthcare service utilization were type of residential area and underlying disease. The qualitative analysis identified; four categories and nine sub-categories. Conclusion: Based on these findings, it is necessary to develop a disaster nursing response model according to the type of residential areas and the number of people.

• Quality Improvement in Health Care
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• v.28 no.1
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• pp.14-33
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• 2022

Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4369-4371
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• 2012

Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.

• Clinical and Experimental Pediatrics
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• v.58 no.12
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• pp.478-483
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• 2015

Purpose: Information on the clinical features of lung abscess, which is uncommon in children, at hospitalization is helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. Methods: The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Results: Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. Conclusion: The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.