• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.269-275
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• 2020

Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient's demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n=107), followed by the anterolateral thigh flap (n=18) and fibula flap (n=10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion: Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.

• Journal of Family Resource Management and Policy Review
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• v.18 no.1
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• pp.115-140
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• 2014

In light of today's socioeconomic scenario, life management skills, especially economic life management skills are essential. This study focuses on a household account book as a tool for economic education. This study aims to assess the characteristics of household economic management in terms of the effect of keeping a household account book on Japanese in their 20s to 30s in a single-family household. It also compares the awareness of the change in economic life behavior between before and after keeping a household account book. Moreover, it analyzes the determinants of continuity in keeping a household account book. This Study used data obtained from an Internet survey of household account books by the Institute for Research on Household Economics in Japan. The study sample consist of 1,255 Japanese in their 20s to 30s who kept household account records for a month as well as preliminary and post-survey information about these people. The results were as follows. First, the average annual income of the subjects was at most 3,000,000 yen; their level of financial assets was at most 1,000,000 yen, their economic life behavior became future-oriented after practice of keep a household account book in that they established a budget and savings plan. Second, keeping a household account book had a positive effect on the people that they have budget and spending plans for the next year. Finally, factors that affected the continuity in keeping a household account book included the experience of keeping one from before.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5279-5284
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• 2015

Background: The study analyzed the long term clinical outcomes of pituitary adenoma cases treated with the first Thailand installation of a dedicated Linac-based stereotactic radiation machine (X-Knife). Materials and Methods: A retrospective review of 115 consecutive pituitary adenoma patients treated with X-Knife at the Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand from 1997 to 2003 was performed. Stereotactic radiosurgery (SRS) was selected for 21 patients (18%) including those with small tumors (${\leq}3cm$) located ${\geq}5mm$. from the optic apparatus, whereas the remaining 94 patients (82%) were treated with fractionated stereotactic radiotherapy (FSRT). Results: With a median follow-up time of 62 months (range, 21-179), the six-year progression free survival was 95% (93% for SRS and 95% for FSRT). The overall hormone normalization at 3 and 5 years was 20% and 30%, respectively, with average time required for normalization of approximately 16 months for SRS and 20 months for FSRT. The incidence of new hypopituitarism was 10% in the SRS group and 9% in the FSRT group. Four patients (5%) developed optic neuropathy (1 in the SRS group and 3 in the FSRT group). Conclusions: Linac-based SRS and FSRT achieved similar high local control rates with few complications in pituitary adenoma cases. However, further well designed, randomized comparative studies between SRS versus FSRT particularly focusing on hormone normalization rates are required.

• Korean Medical Education Review
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• v.22 no.3
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• pp.198-206
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• 2020

This study aimed to identify needed improvements to current evaluation methods in medical school computer-based test (CBT) programs and test environments. To that end, an analysis of the importance and satisfaction was conducted through a survey of 3rd and 4th year medical students who had sufficient experience with CBT programs. Importance performance analysis methodology using the correlation coefficient was applied to assess average satisfaction and importance. The first quadrant (keep up the good work) was a factor of review and time management and test facilities among the conveniences of the CBT program. The second quadrant (concentrate here) was a factor of the convenience of the CBT program and computer monitor and chair factor within the test facilities. The third quadrant (low priority) was a factor of cheating and computer failure. The fourth quadrant (possible overkill) was the location, spacing, and temperature factors of the test facilities. Improvements are needed to reduce 'eye fatigue' and help students focus and understand the questions in the CBT programs. It is necessary to improve computer monitors, desks and chairs, and consider the subject's body type and manager in order to cope with computer breakdown and peripheral failures. Spare computers are needed. These findings are meaningful in that they have been able to identify factors that require improvement in the CBT program and test environment resulting from changes in assessment tools.

• Korean Parent-Child Health Journal
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• v.16 no.1
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• pp.11-16
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• 2013

Purpose: Ethiopia is one of the sub-Saharan countries most affected by high maternal and infant mortality. The government has trained health extension workers (HEWs), the community health workers, to deliver preventive and basic curative health services to community residents in Ethiopia. Very few studies have investigated on-the-job educational effects for HEWs on improvement of their knowledge and performance confidence in maternal and child health care (MCH). This study aimed at identifying the educational effects for HEWs in one health center in Tigray, Ethiopia on improvement of their knowledge in MCH. Methods: Twelve HEWs from 6 health posts participated in this study. A health center officer provided a total of 5 educational sessions on antenatal and postnatal care, family planning, and newborn care from August, 2012 to April, 2013. Ten to 12 items regarding the topics were tested before and after each education. Wilcoxon signed rank test was used to analyze the data. Results: All the HEWs were female with average 4-year working experience. Their knowledge significantly increased after education, except the first session. Their satisfaction on education was greater than 45 points out of 50. Conclusion: This study suggests a focused education for HEWs should continue to improve their capacity on MCH.

• Korean Journal of Construction Engineering and Management
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• v.17 no.1
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• pp.76-82
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• 2016

Decision-making in construction projects often include options features. Such embedded options are difficult to value properly and many decision makers do not have experience in option analysis. The purpose of this paper is to demonstrate how real option analysis can be used to value capital expenditures on construction materials. We propose a real option framework to evaluate decision-making processes involving the purchase of construction materials. A case study was conducted by evaluating the purchase decision-making of solar cells, a good with high price volatility. Using real option analysis two strategies to improve the financial feasibility of installing a solar panel system were derived. The first strategy involves using a price cap that gives the project manager the right, but not obligation, to buy the modules for a predefined price during the next year. The second strategy is to defer the purchase of the solar cells until future price information becomes clearer. Both of the strategies in the case study were valued using the binominal model. This study will help to improve the financial feasibility of purchasing construction materials with high price volatility by including the value of managerial flexibility.

• The Journal of Korean Medical History
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• v.25 no.1
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• pp.43-51
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• 2012

Smallpox and measles might be the typical epidemics through Choson Danasty. Especially Sookjong was the first king who suffered from smallpox during the period of his reign. This study was examined critically focused on the Clinical Records about Smallpox which occurred in the 9th year of Sookjong's reign. The clinical records in Seungjeongwon Ilgi("承政院日記") was the main source and the Annals of the Joseon Dynasty was reffered. It tells us that Sookjong caught infectious disease, smallpox spread in town and the whole process of smallpox. Seungmagalgeuntang(升麻葛根湯) and hwadoktang(火毒湯) were given at the early term for treating Sookjong's smallpox, but later on, Bowontang(補元湯) was given for the treatment of smallpox. It showed us the medical view which placed emphasis on the vital force of human body. A dermatologist, Yoo Sang had joined since the beginning of the treatment and Siyakchung(侍藥廳) was established for Sookjong. Sasunghoichuntang(四聖回天湯) which was Chunyoohyung(全有亨)'s prescription showed us enough clinical experience and the ways of treatments. At the same time, the medical culture at that time was well known through the fact that smallpox was taboo among the royal family.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.229-232
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• 2009

Purpose: Kimura's disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied with eosinophila. We shared our experience of two cases of Kimura's disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After operation, steroid therapy was started. Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura's. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura's disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura's disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura's disease during the follow up period.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.32-41
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• 1992

From August 1982 to December 1991, 58 consecutive infants with tetralogy of Fallot underwent primary repair. Age ranged from 22 days to twelve months [n=58, 8.7$\pm$2.7 months] and body weight from 3.1 to 13 kilograms [n=58, 7.8$\pm$1.7 kilograms]. Qne infant had absence of the pulmonary valve; one had Ebstein`s anomaly and one had supramitral ring. Thirty-two patients [56%] experienced anoxic spell. Preoperative pulmonary artery indices were measured in 38 cases, ranging 126-552mm2/M2BSA[n=38, 251$\pm$79mm2/M2BSA]. All infants required a right ventricular outflow tract patch; in 41, the patch extended across the pulmonary valve annulus, in 13 of them, monocusps were constructed. All had patch closure of ventricular septal defect. Two infants had REV operation for avoiding injury to the canal branch of the right coronary artery which cross the right ventricular out flow tract. Post repair PRV/LV were measured at operating room in 40 cases, which revealed mean value of 0.49$\pm$0.12 [range: 0.25-0.74]. The hospital mortality was 10.3% [6 patients], and causes of deaths were right heart failure due to sustained right ventricular hypertension[4] and right ventricular outflow tract obstruction, intractablesuraventricular tachyarrhythmia[1], hypoxia[1] due to residual right to left shunt across the atrial septal defect in patient associated with Ebstein`s anomaly. All infants were doing well at follow-up from 1 to 101 months[20.6 months /patient, 1, 072 patient-month] Serial postoperative echocardiograms revealed no residual ventricular septal defects and estimated RVOT gradients between 0 and 40 mmHg except 3 cases [50, 50, 60 mmHg]. There were no late deaths and late ventricular arrhythmias or congestive heart failure. Redo operations were done in 2 cases because of residual right ventricular outflow tract obstruction. This experience with infants with tetralogy of Fallot suggests that, if mortality is tolerable, eletive repair of tetralogy of Fallot could be reasonably undertaken during the first year of life, and even better results could be anticipated along with improvement of methods of myocardial protection and postoperative care.

• Journal of Engineering Education Research
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• v.13 no.6
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• pp.143-151
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• 2010

This paper presents a case study on the assessment of program outcomes using the capstone design course based on 16-year management experience and improvements of the school of mechanical design and automation engineering in the seoul national university of science and technology. First, the program outcomes related with the capstone design course are introduced, and the assessment methods and items are described. Based on them, the assessment results in 2008 were obtained and a strategy to improve the results were built after analyzation. As for the strategy, we revealed the assessment items and good examples in an internet web site in advance. As a result, we were able to obtain about 3.3% improved assessment results in 2009. Finally, the validity, efficiency, internal stability, and sustainability of the assessment of the program outcomes using the capstone design course are addressed in terms of a notion of the course-embedded assessment.