• Title/Summary/Keyword: First Clinical Experience

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Job Satisfaction of Occupational Therapists Working in Sensory Integration Treatment Setting (감각통합치료 세팅에서 일하는 작업치료사의 직무만족도에 관한 연구)

  • Chang, Moon-Young;Lee, Mi-Hee;Jung, Hye-Young;Jung, Nam-Hae
    • The Journal of Korean Academy of Sensory Integration
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    • v.10 no.1
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    • pp.33-44
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    • 2012
  • Objective : The aim of the study was to investigate the job satisfaction of occupational therapists(OTs) who work in sensory integration treatment setting, and to analysis for factors influencing the satisfaction. Methods : Data were obtained from 62 OTs who had registered Korean Academy of sensory integration through a survey. Results 1 : Job satisfaction according to general characters: OTs who were above 35 years old and take the treatment course for sensory integration felt the highest total job satisfaction. OTs who are above 35 years old and have clinical experience under 12 month felt the highest salary satisfaction. OTs who are under 25 years old felt the highest promotion satisfaction. Female OTs felt higher colleagues relationship satisfaction than male OTs. 2. Job satisfaction according to work environment: OTs who work with 5 to 10 colleagues and work at private clinic felt the highest total job satisfaction. OTs who spend time treating patients more than 45 hours per week and work at private clinic. OTs who work with 5 to 10 colleagues felt the highest promotion and institute satisfaction. OTs who work at the disabled children care center considered change their job more than others. Conclusions : To improve job satisfaction of OTs, we need to consider size of organization, type of institutes. And we have to define role and specialty of OTs who work in various sensory integration treatment setting.

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Clinical Experience of Small-cell Carcinomas of the Stomach (위에 발생한 소세포암의 임상 경험)

  • Kim, Hyoung-Ju;Park, Moon-Hyang;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.252-259
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    • 2005
  • To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

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Male Breast Cancer: 20 Years Experience of a Tertiary Hospital from the Middle Black Sea Region of Turkey

  • Serarslan, Alparslan;Gursel, Bilge;Okumus, Nilgun Ozbek;Meydan, Deniz;Sullu, Yurdanur;Gonullu, Guzin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6673-6679
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    • 2015
  • Background: Male breast cancer is a rare neoplasm, and its treatments are based on those of female breast cancer. This study aimed to analyze 20 years of male breast cancer clinical characteristics and treatment results from the Middle Black Sea Region of Turkey. Materials and Methods: A retrospective analysis of 16 male breast cancer patients treated in our tertiary hospital between 1994 and 2014 was performed. Epidemiologic data, tumor characteristics, and treatments were recorded and compared with 466 female breast cancer ((premenopausal; n = 230) + (postmenopausal n = 236)) patients. The 5-year disease-free and overall survival rates were calculated. Results: Male breast cancer constituted 0.1% of all malignant neoplasms in both sexes, 0.2% of all malignant neoplasms in males, and 0.7% of all breast cancers. The mean patient age in this study was $59.8{\pm}9.5$ (39-74) years. The mean time between first symptom and diagnosis was $32.4{\pm}5.3$ (3-60) months. Histology revealed infiltrative ductal carcinoma in 81.3% of patients. The most common detected molecular subtype was luminal A, in 12 (75%) patients. Estrogen receptor rate (93.8%) in male breast cancer patients was significantly higher than that in female breast cancer (70.8% in all females, p = 0.003; 68.2% in postmenopausal females, p = 0.002) patients. Most of the tumors (56.3%) were grade 2. Tumor stage was T4 in 50% of males. The majority (56.3%) of the patients were stage III at diagnosis. Surgery, chemotherapy, radiotherapy and endocrine-therapy were applied to 62.5%, 62.5%, 81.2% and 73.3%, respectively. Loco-regional failure did not occur in any of the cases. All recurrences were metastastic. The 5-year disease-free and overall survival rates in male breast cancer patients were 58% and 68%, respectively. Conclusions: Tumors found in male breast cancer patients were similar in size to tumors found in females, but they advanced to T4 stage more rapidly because of the lack of breast parenchymal tissues. The rate of estrogen receptor expression tended to be higher in male breast cancer patients than in female breast cancer patients. Metastasis is the most important problem in initially non-metastatic male breast cancer patients.

Revision of the Questionnaire for the Sasang Constitution Classification (사상체질진단설문지(四象體質診斷設問紙)의 문항(問項) 개정(改定)에 대한 연구(硏究))

  • Kim, Sang-Bok;Lee, Soo-Kyung;Lee, Eui-Ju;Choi, Sun-Mi;Koh, Byung-Hee;Song, Il-Byung;Jeong, Yong-Jae
    • Journal of Sasang Constitutional Medicine
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    • v.15 no.3
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    • pp.100-117
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    • 2003
  • Background In Sasang Constitutional Medicine (SCM), human beings are classified into four constitutions: Taeyangin, Taewnin, Soyangin, and Soeumin. SCM presents various lifestyles and treatments for each constitution. The problem of SCM is that its diagnosis is so subjective that the result of the diagnosis depends on the doctor. In order to solve this problem, multiple approaches have been objectively researched. To use a questionnaire is the most common method among the different approaches. Since there are a few problems in the Questionnaire for the Sasang Constitution Classification II (QSCC II), which in recent days has been used frequently, the necessity of a new questionnaire has arisen. Objective The purpose of this study is to develop a new questionnaire for the objectivity of the Sasang Constitution Classification by complementing the existing questionnaire. Methods In order to search for the existing questionnaire's problems, I first compare the ratio of the amount of questions regarding external appearance to that of questions of mental characteristics and physiologic & pathologic symptoms in QSCCII and QSCCII +. We created the new questionnaires by reinterpreting ${\ulcorner}Dongyi$ Soose $Bowon{\lrcorner}$ through SCM professors' and medical residents' discussion and by adding some items related to the diagnosis about the constitution from other SCM books and clinical experience. Results 1. The new questionnaire for the Sasang Constitution Classification is self-reported questionnaire based on a multiple choice system of 4 questions. 2. The new questionnaire for the Sasang Constitution Classification consists of 28 questions, which include 7 questions about external appearance, 4 questions about mental characteristics, and 17 questions about physiologic & pathologic symptoms. 3. The new questionnaire for the Sasang Constitution Classification consists of 24 questions of Taeyangin, 28 of Taeumin, 28 of Soyongin, 28 of Soeumin. 4. We will have to verify validity and reliability of new questionnaire for rhe Sasang Constitution Classification.

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Reverse Total Shoulder Arthroplasty: Where we are? "Principles" (견관절 역행성 인공관절 치환술의 원칙)

  • Noh, Kyu-Cheol;Suh, Il-Woo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.105-110
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    • 2011
  • Purpose: The purpose of this article is to identify and understand the complications of RTSA and to review the current methods of preventing and treating this malady. Materials and Methods: Previous constrained prostheses (ball-and-socket or reverse ball-and-socket designs) have failed because their center of rotation remained lateral to the scapula, which has limited of the motion of the prostheses and produced excessive torque on the glenoid component, and this leads to early loosening. The Grammont reverse prosthesis imposes a new biomechanical environment for the deltoid muscle to act, thus allowing it to compensate for the deficient rotator cuff muscles. Results: The clinical experience does live up to the lofty biomechanical concept and expectations: the reverse prosthesis restores active elevation above $90^{\circ}$ in patients with a cuff-deficient shoulder. However, external rotation often remains limited and particularly in patients with an absent or fat-infiltrated teres minor. Internal rotation is also rarely restored after a reverse prosthesis. Failure to restore sufficient tension in the deltoid may result in prosthetic instability. Conclusion: Finally, surgeons must be aware that the results are less predictable and the complication/revision rates are higher in revision surgery than that in the first surgery. A standardized monitoring tool that has clear definitions and assessment instructions is surely needed to document and then prevent complications after revision surgery.

Surgical experience of esophageal disease: report of 75 cases (식도질환의 외과적 치료 75례)

  • 박창권
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.231-242
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    • 1983
  • A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.

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A Study about Restraint Use in Care of Patients with Psychiatric Disorders (일 정신병원에서 발생한 강박 처치에 관한 연구)

  • An, Hyo Ja;Kim, Eun Ha;Chung, Young Hae;An, Jung Sim;Cho, Won Ae;Park, Joung Hwa
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.3
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    • pp.432-442
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    • 2013
  • Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

A Qualitative Research on Role Conflict Experiences of Clinical Dental Hygienists (치과위생사 역할갈등 경험에 관한 질적연구)

  • Lee, Soon-Young;Lim, Soon-Ryun
    • Journal of dental hygiene science
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    • v.18 no.4
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    • pp.241-251
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    • 2018
  • This study was based on the experience of dental hygienists' role conflict, and attempted to grasp the nature of the dental hygienist role conflict factor, constituent factor and coping. Giorgi's phenomenological method was used to analyze data collected through in-depth interviews with nine dental hygienists working in a dental clinic. The analysis revealed three central meanings: task scope, role conflicts, and role conflict management style and limitations. In the first category, task scope, the range of the legal scope, and the duties performed by the dental hygienist differed slightly. The second category included role conflict due to interpersonal relationship, work, work environment, competence, and identity as a professional because of role conflict. The third category included the role conflict management style and limitations. Dental hygienists tried to solve the role conflict situation through various efforts. In the face of the reality that the conflict is not solved despite such efforts, the dental hygienists felt the limitation and chose to leave. Dental hygienists are dissatisfied with their roles because of confusion regarding professional values and lack of awareness of the professional workforce due to differences between legal scope and actual practice. Based on the results of this study, it is necessary to develop a tool to quantitatively measure the level of role conflict in dental hygienists and to conduct follow-up studies on the effects of coping strategies by role conflict situations.

Prognostic Factor of Laryngeal Papillomatosis: 20 Years Experience (후두유두종증의 예후인자: 20년간의 임상 경험을 통한 분석)

  • Chung, Eun-Jae;Hong, Seok-Jin;Cho, Jae-Gu;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Jung, Kwang-Yoon
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.145-148
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    • 2010
  • Background: Laryngeal papillomatosis, which is cased by human papillomavirus, is the most common benign neoplasm of the larynx. However, the prognosis of this disease remains really unpredictable. The aim of this paper is to determine whether any clinical features at the time of diagnosis could predict its course. Material and Method: Eighty-six patients treated at our institution during the last 20 years were analyzed retrospectively. All patients had microsurgery under general anesthesia. All patients' follow-up period was more than 1 year. We divided the patients into 1) Juvenile versus adult group based on their age 20, 2) single surgical method with laser versus dual surgical method with laser and microdebrider group, and 3) single subsite versus multiple subsites group. And we compared the therapeutic outcome. Results: The recurrence rate was 100% (15 patients) in the JP group and 56% (40 patients) in the AP group. Juvenile versus adult group was the only independent prognostic factor by univariate, and multivariate analysis. Microdebrider resection technique and multiple subsites were not associated with treatment result. Time period from the first surgery to recurrence detection was different statistically only for the age group. The number of surgery in the JP group ranged from 1 to 31 (mean 8.8). In the AP group the number of surgery ranged from 1 to 25 (mean 3.7). It was statistically different. Conclusion: Prognosis for the laryngeal papillomatosis remains unpredictable. Only patients' age was the only independent prognostic factor.

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Posterolateral Thoracotomy versus Muscle-sparing Vertical Thoracotomy (후측개흉술과 근육보존수직개흉술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Hyun-Tae;Kim, Jung-Taek;Sun, Kyung
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.509-512
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    • 1998
  • Although posterolateral thoracotomy(PLT) has been a standard thoracic incision in resection surgery of the lung for surgeons to achieve a good surgical field, there remains concern about severing a group of thoracic muscles remains. Muscle-sparing vertical thoracotomy (MVT) is an alternative to PLT, which gives cosmetic result and may preserve motion of the shoulder girdle as well as respiratory function of the patient in the early postoperative period. However, surgeons tend not to perfer it because of limited surgical field from the vertical wound made on the lateral thoracic wall. The purpose of this study is to compare the surgical outcomes of PLT versus MVT. We retrospectively reviewed 29 patients(15 who had PLT and 14 who had MVT, organized into those two groups) who had undergone lung resection surgery in our institute. There were no clinical differences between the two groups in terms of operation time, estimated amount of blood loss during the operation, amount of chest drainage on the first and the second postoperative day, duration of chest tube placement, incidence and amount of transfusion, and postoperative complications. We conclude that, from our limited experience, MVT can be applied to lung resection surgery as safely as PLT and that it may have a beneficial role for the patient with compromised lung function in addition to cosmetic effect.

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