The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator's decisions are discussed.
The Institute of Medicine in its report "Clinical Practice Guidelines we can trust" defined standards for clinical practice guidelines. However, many guidelines continue to rely on expert opinion and lack a formal framework for moving from evidence to recommendations. These guidelines may or may not be labeled as "consensus statements" and do not meet contemporary standards for guideline documents we would refer to as "evidence-based". Therefore, the Grading of Recommendations Assessment, Development and Evaluation working group developed a novel, rigorous and transparent approach to grading certainty (quality) of evidence. In addition, it created a system for "moving from evidence to decisions", for example for the development of evidence-based guidelines. In this article, we aim to introduce this approach to appraising the certainty of relevant evidence and estimate the benefits and detriments of health care interventions within the larger context of evidence-based medicine.
The purpose of this study was to apply the ADDIE instructional design model to develop multimedia rich project-based learning methods for effective instruction in a Korean mechanical engineering high school. This study was conducted as action research based on a high school situation. The study included 40 participants in a class purposively selected from 52 classes at 2080 student high school. Data were collected through observations, surveys and artifacts. Results indicated the multimedia rich project-based learning allowed students to take part in learning activities and there was close cooperation with and among group members to create better products. Also, the flexibility in the project-based learning environment allowed the participants to make decisions about their abilities, resources, and plans. Recommendations and implications for teacher educators as well as in-service and pre-service teachers are also presented.
Lee Youn Goo;Ahn Ki Jung;Suh Chang Ok;Kim Gwi Eon;Lohn John J.K.;Ahn Hee Jung;Choi In Joon;Kim Byung Soo
Radiation Oncology Journal
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v.7
no.2
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pp.235-245
/
1989
Rhabdomyosarcoma is a highly malignant soft tissue sarcoma that can arise in any site of the body containing striated muscle or its mesenchymal analgae. It is the most common childhood sarcoma with two peak age frequencies, one at ages 2 to 6, and one in the adolescence. The site, stage and extent of disease, and pathologic characteristics of the tumor contribute to prognostic factors that influence therapeutic decisions. The results of treatment of 52 patients with rhabdomyosarcoma, who were treated at Department of Radiation Oncology, Yonsei University College of Medicine, Yosei Cancer Center from 1976 to 1987 were retrospectively analyzed. The most frequent clinical group and primary sites were IRS group III (57.7%) and head and neck (42.3%) including orbit (11.5%) and parameningeal region(13.5%). The overall and disease free 5 year survival rate of eligible 41 patients were 31.7%, 29.3%, respectively. The complete remission (CR) rate was 50% in clinical group III and 0% in IV. Primary tumors of the orbit, clinical group 1 and embryonal subtype had the best prognosis. The Survival rate was improved by additiion of chemotherapy to operation and radiation therapy.
Park, Eun-Joo;Park, Seung-Guk;Kwon, Ji-Hye;Cheon, Seung-Won;Kim, Hyo-Eun;Yoo, Sun-Mi
Health Communication
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v.13
no.2
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pp.159-166
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2018
Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.
Journal of Family Resource Management and Policy Review
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v.10
no.1
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pp.83-105
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2006
The purposes of this study were to classify types of consumption values and to examine 5 types of art appreciation of university students in Seoul. Five types of art appreciation included fine art exhibition(including photographs, architects, calligraphy works), classical and opera performance, traditional Korean music performance, drama and musical performance, dance performance. The sample for this study consisted of 422 university students of five universities in Seoul. The data were collected using the structured questionnaires. The statistical methods used for the analysis were descriptive statistics, chi-square, factor analysis, and cluster analysis. The major findings are as follows. 1. The result of factors for consumption values of students emerged four factors. These were called as 'materialism', 'honor centered', 'family centered', 'hedonism' value. 2. The cluster analysis was conducted based on these four factors. The result showed 3 groups of consumption value which were called as 'material' honor value group', 'family value group', 'hedonic value group'. 3. The consumption value of university students did not significantly differ according to their demographic variables. 4. The behavior of art appreciation of university students significantly differed by their demographic characteristics and consumption value. The material' honor valued group showed the least chances to make decisions on art appreciation for one's own, which reflected that this group appreciate art to satisfy their honors rather than to enjoy art itself. They also showed the most chances to consider the renownedness of the art work or artists among three groups. And they showed the least chances to pay for the tickets for art appreciation, all of those meant that they appreciate arts unvoluntarily in situational condition. The family valued group showed the most chances to pay for the tickets when they appreciate arts. And therefore they were most susceptible for the prices. The hedonic valued group showed the most interests in art. They decided to appreciate art for their own, and they considered the contents and the highness in the level of the art the most when they appreciate art. And they show the most intention of participation in drama/musical performances, which reflect their interests in hedonic values. Based on these results of this study concluded that the consumption values of university students affected their behavior of art appreciation. Thus, university students' behavior on art appreciation can be effectively developed by education according to their consumption values.
Journal of Korean Home Economics Education Association
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v.31
no.3
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pp.57-71
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2019
This study intended to analyze the ethical clothing consumption behavior of female adolescents and use it as a basic data for education. Specifically, the female adolescents were classified according to their shopping orientation and then the differences among these groups were examined in terms of their ethical consumption behavior of clothing products, i.e., buying, using and disposing. As a result, three groups were identified: pleasure-seeking, intermediate, independence pursuing according to the shopping orientation sub-factors (loyal, enjoyment, impulsive, imitative and independent). The pleasure-seeking group were more likely to conduct ethical use behavior of clothing products, while the independence-pursuing group conducted more ethical buying and ethical disposing behavior. The lower their desire to enjoy shopping itself, the more cautious they are about their own decisions, and the more confident they about buying from the brand and store they liked, the more likely they were to conduct ethical buying behavior of clothing products. On the other hand, when the emotional and desire-seeking tendencies are combined with independent shopping tendencies, the more likely they conduct ethical use behaviors. In addition, the more they make independent purchasing decisions, the more likely they are to conduct ethical disposal behaivors. The results of this study suggest that providing detailed consumer education that considers individual differences in shopping orientation is needed.
Park, Yong-Wook;Kim, Ki-Jo;Yang, Hyung-In;Yoon, Bo Young;Kim, Sang Hyon;Kim, Seong-Ho;Kim, Jinseok;Oh, Ji Seon;Kim, Wan-Uk;Lee, Yeon-Ah;Choe, Jung-Yoon;Park, Min-Chan;Lee, Sang-Heon
Journal of Rheumatic Diseases
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v.24
no.4
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pp.227-235
/
2017
Objective. Failure of first-line anti-tumor necrosis factor (TNF) agents in in rheumatoid arthritis patients leads to decisions among second-line biologic agents. To better inform these decisions, the therapeutic effectiveness of rituximab is compared with other second-line biologic agents in this observational study. Methods. Between November 2011 and December 2014, study subjects were observed for 12 month periods. Patients with an inadequate response to initial anti-TNF agent received either rituximab or alternative anti-TNF agents (adalimumab/etanercept/infliximab) based on the preference of patients and physicians. The efficacy end point of this study was the change in 28-joint count Disease Activity Score (DAS28) at six and 12 months from baseline. Safety data were also collected. Results. Ninety patients were enrolled in the study. DAS28 at six months did not change significantly whether the patients were treated with rituximab or alternative anti-TNF agents in intention-to-treat analysis (n=34, $-1.63{\pm}0.30$ vs. n=31, $-2.05{\pm}0.34$) and standard population set analysis (n=31, $-1.51{\pm}0.29$ vs. n=24, $-2.21{\pm}0.34$). Similarly, the change in DAS28 at 12 months did not reach statistical significance ($-1.82{\pm}0.35$ in the rituximab vs. $-2.34{\pm}0.44$ in the alternative anti-TNF agents, p=0.2390). Furthermore, the incidences of adverse events were similar between two groups (23.5% for rituximab group vs. 25.8% for alternative anti-TNF agents group, p=0.7851). Conclusion. Despite the limitations of our study, switching to rituximab or alternative anti-TNF agents after failure of the initial TNF antagonist showed no significant therapeutic difference in DAS28 reduction.
Journal of the Korean Society of Clothing and Textiles
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v.40
no.3
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pp.465-479
/
2016
Some groups do ethical activities (such as ethical slogan t-shirt campaigns) only to complete the requirements for ethical duty; consequently, some people question the effectiveness of those products. The attributes of ethical slogan t-shirts should be considered seriously to reduce skepticism when planning a campaign. Researchers can also suggest a new purpose for ethical t-shirts using an ethical message. In study 1, we conduct a conjoint analysis that suggests realistic multi-attribute choice decisions. The suggested multi-attributes wear design aesthetic (high/low), price (high/low), where we donate (close/far), and the size of firm (big/small). In addition, participations were divided into two groups according to eco-friendly attitudes to confirm differences in choices between two groups. Study 1 showed that price is the most important attribute, but design aesthetic also remains important. In addition, a group that has a high eco-friendly attitude thought "where we donate" was more important than other groups. In study 2, a pre-post approach investigated wearers' attitude changes. We also divided participants into two groups and one group wear high level design aesthetic t-shirts (and vice-versa) to measure the attitude change difference. As a result of study 2, the wearers partially changed their eco-friendly attitudes. The group that wore high design aesthetic t-shirts showed a greater difference than other groups. Through this study, we conclude that customers seriously considered the design aesthetic. Finally, wearing ethical slogan t-shirts can change the attitudes of wearers.
The Journal of Korean Association of Computer Education
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v.11
no.5
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pp.19-32
/
2008
It is necessary to study creative problem solving(CPS) in cooperative level because numerous studies have reported that group approaches to CPS are more effective than individual approaches. There are also lots of researches that an online environment is effective to promote cooperative interactions among group members. Therefore, the purpose of this study is to develop an online support system for cooperative and creative problem solving. First, in this paper we created an integrated CPS model from existing CPS models. Second, we designed principles of an online cooperative CPS(CCPS) based on the integrated CPS model. Third, we developed an online support system for the cooperative CPS. Lastly, we conducted formative evaluations of the developed system and suggested ideas for improvement of the system. The developed system provides an effective and efficient online learning environment for CCPS. CCPS means the cooperative thinking processes to solve certain problems through identifying problems, stating problems, reviewing the data related withe the problems, producing creative ideas and making group decisions related with the solutions.
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