• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.777-783
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• 2020

Objective : To compare the accuracy and breach rates of freehand (FH) versus navigated (NV) pedicle screws in the thoracic and lumbar spine in patients with metastatic spinal tumors. Methods : A retrospective review of adult patients who underwent pedicle screw fixation in the thoracic or lumbar spine for metastatic spinal tumors between 2012 and 2018 was conducted. Breaches were assessed based on the Gertzbein and Robbins classification and only screws placed >4 mm outside of the pedicle wall (lateral or medial) were considered breached. Results : A total of 62 patients received 547 pedicle screws (average 8 per patient) - 34 patients received 298 pedicle screws in the FH group and 28 patients received 249 screws in the NV group. There were 40/547 breaches, corresponding to a breach and accuracy rate of 7.3% and 92.7%, respectively. The breach rate was 9.7% in the FH group and 4.4% in the NV group (chi-squared test, p=0.017); this corresponded to an accuracy rate of 90.3% and 95.6%, respectively. Only one patient from the overall cohort (in the FH group) required revision surgery due to a medial breach abutting the spinal cord (1.6% of all patients; 2.9% of FH patients); no patient suffered organ, vessel, or neurological injury from screw breaches. Conclusion : Navigated pedicle screw placement in patients with metastatic spinal tumors has a significantly higher radiographic accuracy compared to the FH technique. However, the revision surgery was low and no patient suffered from clinically-relevant breach. Navigation also offers the advantage of real-time localization of spinal tumors and aids in targeting and resection of these lesions.

• Journal of Pharmaceutical Investigation
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• v.39 no.4
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• pp.233-242
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• 2009

Bioequivalence (BE) studies provide important information in the overall set of data that ensure the availability of safe and effective medicines to patients and practitioners. Thus its determination of proper criterion for assessing BE is very important. BE is frequently expressed or measured by estimating area under the plasma concentration-time curve (AUC) and maximum concentration ($C_{max}$) that are reflective of systemic exposure. In all countries except Canada, the acceptance criteria of BE is that the 90% confidence interval of difference in the average values of logarithmic AUC and $C_{max}$ between test and reference products is within the acceptable range of log(0.8) ${\sim}$ log(1.25). In Canada, unlike other countries, point estimation instead of applying 90% confidence interval is applied to assess $C_{max}$ which is, in essence, more variable than AUC. We also compared other parts of BE guidelines which include a fed study, average BE (ABE), scaled-ABE, population BE (PBE), individual BE (IBE), dropout & withdrawal, sampling frequency & time and number of subjects. This article reviews the most recent BE guidelines of Korea, USA, Europe, Canada and Japan, highlighting the differences focused on Korean BE guidelines compared to other countries. It will help us to revise BE guideline of Korea reflecting international trends. Finally, it is strongly recommended that the extended acceptance criterion for the highly variable drug among all the considering aspects for the revision of current BE guideline has to be adopted into Korea BE guideline in the nearest future.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.433-440
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• 2019

Background Mastectomy in male transgender patients is an important (and often the first) step toward physical manhood. At our department, mastectomies in transgender patients have been performed for several decades. Methods Recorded data were collected and analyzed for all male transgender patients undergoing mastectomy over a period of 24 years at our department. Results In total, 268 gender-reassigning mastectomies were performed. Several different mastectomy techniques (areolar incision, n=172; sub-mammary incision, n=96) were used according to patients' habitus and breast features. Corresponding to algorithms presented in the current literature, certain breast qualities were matched with a particular mastectomy technique. Overall, small breasts with marginal ptosis and good skin elasticity allowed small areolar incisions as a method of access for glandular removal. In contrast, large breasts and those with heavy ptosis or poor skin elasticity often required larger incisions for breast amputation. The secondary correction rate (38%) was high for gender reassignment mastectomy, as is also reflected by data in the current literature. Secondary correction frequently involved revision of chest wall recontouring, suggesting inadequate removal of the mammary tissue, as well as scar revision, which may reflect intense traction during wound healing (36%). Secondary corrections were performed more often after using small areolar incision techniques (48%) than after using large sub-mammary incisions (21%). Conclusions Choosing the suitable mastectomy technique for each patient requires careful individual evaluation of breast features such as size, degree of ptosis, and skin elasticity in order to maximize patient satisfaction and minimize secondary revisions.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.57-63
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• 2022

Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.415-421
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• 2023

The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

• Journal of Korean Home Economics Education Association
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• v.26 no.4
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• pp.129-146
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• 2014

This study is a fundamental research in the field of home economics education to enforce vocational competencies. It was carried out in the purpose of examining the recent economical and social environmental changes and its management system related to the vocational training in the field of home economics education. It seeks change in direction in relation to the National Competency Standard(NCS) based on revisions in the educational system. The method of study was mostly through reference and data analysis, professional advisory and public hearing. The main research results are as follows. First, the main environmental change factors in relation to vocational training have been integrated to the changes in; population structure, gender related economic activities, generation composition, communications technology, and innovation of living technique. These change factors are forecasting innovations in related industries, lifestyle changes, demand for manpower and changes in capabilities required for each specific profession. Second, according to the analysis of current home economics education training, vocational home educations high school accounts for 9.4% of the total number of specialized high schools, where 8 standard departments are specialized in and characterized into 137 different department names. Despite differences among departments, overall employment rate of graduates were measured 44.7%, which rates above the entrance rate of 41.9%. These numbers show great change since 2010(overall employment rate 16.9%, entrance rate 75.2%), a meaningful outcome resulting from changes in policy from the previous employment-centered education system. Third, NCS based on high school vocational home economics education system revision and investigations in change of direction in vocational home economics, this study attempts to provide background for revision from the development of NCS. It also provides proposals for restructuring division of current classification and departments of home economics education, and propositions for further future research.

• The Journal of the Korea Contents Association
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• v.17 no.8
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• pp.610-618
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• 2017

Sex offense by medical practitioners has been occurring continuously in Korea leading to not only patients but the general public expressing anxiety and increased distrust in the medical field. The government has been pushing ahead with the legislation or revision of law to increase the penalties on sexual offenders in response to requests for a stricter legal framework to address sex offense cases and has expressed a strong commitment to actively resorting to administrative corrective measures towards sexually offending medical practitioners. Unlike such an overall social atmosphere, the Judiciary that is in charge of applying the law seems not to perceive the seriousness of sex offense cases committed by medical practitioners. A doctor who had sexually assaulted a middle school female student during medical treatment at a pediatric hospital was found innocent by the supreme court, which was a ruling in direct contrast to overall public sentiment. As such, this study seeks to analyze the precedent on cases involving sex offense by medical practitioners with a focus on the above-mentioned case and present implications. The study seeks to dispel distrust in the overall medical field by addressing the gap in legal interpretation towards sex offense committed by medical practitioners and thus provide basic data that can help the general public receive quality medical services in a safer environment.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.183-188
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• 2009

There has been a need to update the current Codex nutrient reference values (NRVs) which had been established following the Helsinki Consultation in 1988. The main purposes of NRVs are to help consumers compare the nutrient content of different food products and estimate the usefulness of a food product in terms of its percentage contribution to the overall healthful diets. The establishment of Codex NRVs for labelling purposes is intended to facilitate the goals of protecting consumers' health and ensuring fair practices in food trade. When revising the Codex NRVs several issues are needed to discussed, which are: 1) Consideration of population groups whether to have one set of NRVs for general population or to have several sets of NRVs for each population groups, 2) Determination of scope of nutrients such as what nutrients to include and what reference values to choose and 3) Development of principles for establishing NRVs such as the selection of suitable reference values among many including recommended intake/recommended dietary allowances, estimated average requirement and upper levels to extract NRVs. This paper will discuss the above issues and the inputs and efforts that the Korean Nutrition Society had put into to carry out the project, "International Collaboration on the Revision and Addition of the Codex Nutrient Reference Values for Food Labelling Purposes," and to ascertain relevant scientific principles and evidences that are utilized for establishment and revision of the Codex NRVs.

• Clinical and Experimental Pediatrics
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• v.56 no.2
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• pp.68-74
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• 2013

Purpose: To evaluate the effectiveness of new management policies on the incidence of invasive Candida infections Methods: This observational study involved a retrospective analysis of the patients' medical records. In total, 99 very low birth weight infants, who were admitted to the neonatal intensive care unit at Ajou University Hospital from January 2010 to December 2011, were enrolled for the study. Period I, defined as the period before the revision of management policies, comprised 57 infants; whereas, period II, defined as the period after the implementation of new management policies, comprised 42 infants. The new management policies entailed a reduction in antibiotic and histamine type 2 receptor blocker (H2 blocker) use, duration of central venous catheterization, and duration of endotracheal intubation. Results: There was a significant overall decrease in the use of antibiotics including 3rd generation cephalosporin and H2 blockers (P<0.05), and a significantly lower incidence of invasive Candida infections in period II as compared to period I (0/42 vs. 6/57, respectively; P=0.037). Comparison between infants with invasive Candida infections (n=6) and those without (n=93) showed that gestational age (odds ratio [OR], 0.909; 95% confidence interval [CI], 0.829 to 0.996; P=0.042) and the duration of 3rd generation cephalosporin use (OR, 1.093; 95% CI, 1.009 to 1.183; P=0.029) were statistically significant risk factors. Conclusion: The new management policies effectively decreased overall use of antibiotics, especially 3rd generation cephalosporin, and H2 blockers, which led to a significantly lower incidence of invasive Candida infections.

• Journal of Korean Home Economics Education Association
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• v.10 no.1
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• pp.29-39
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• 1998

The lack of characteristical understanding of the Home Economics Education will have difficulty in achieving the goal of the Home Economics Education. To allow the Home Economics Education class in school contribute toward the enhancement of the quality of life, it is inevitable to reinforce the recognition of the importance and necessity of the Home Economics Education and to newly propose a directional guidance forward the coming 21st century. The purpose of this study was to provide basic data for planners of the future Home Economics Education by surveying research administrators in charge of programming the overall school curriculum. This study was conducted under the following procedure to have the outcome as follows ; 1. Answers from respondents of age over 50 or careers over 16 years tended to grasp the goal of Home Economics Education in relation to the enhancement of quality of life rather than to the accumulation of knowledge, skill or capacity. 2. Of all the surveyed, 9.64% regarded Home Economics Education as an essential part of school education and the positive ratio was higher with younger respondents. 3. To the question asking if the high school Home Economics Education could have influence on one's capacity, 97.2% of the answerers said yes. The respondents with career under 15 year showed 100% of positive agreement in this matter and of age under 40 marked much higher ratio of 98.84% than the elders. 4. The overall recognition of the necessity for separate sections in Home Economics Education programmed in accordance with the 6th Revision of High School Curriculum displayed a considerably high ratio, with a little differences among age and job groups.