• Archives of Plastic Surgery
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• 제43권5호
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• pp.451-456
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• 2016

Background Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. Methods The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05). Results Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level. Conclusions Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.

• 보건행정학회지
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• 제24권3호
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• pp.205-218
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• 2014

Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

• 한국환경교육학회지:환경교육
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• 제15권2호
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• pp.86-99
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• 2002

The purpose of this study is to make clear the management of Environmental Education in Elementary school in Korea. To accomplish this purpose, The research for the actual condition of management of Environmental Education according to school, grade, and class was progressed. The researcher was analyzed Hindrance Factors of Sound Environmental Education in School and presented some suggestion on the basis of above-mentioned findings. On one side, the method of research is a case study on qualitative based way. A case study was conducted with it's focus on public elementary school in Seoul. As for major research methods, observation by participating in school field and in-depth interview were respectively employed; subsidiary methods included literature study. The findings of this study are as belows: First, Environmental Education was not managed practically with specific way in school. Second, Environmental Education by direct and actual outdoor experience was unusual. Third, most of class school work about Environmental Education was focused on not only the type of prescription after the environmental problem but also, the treatment of articles in newspaper and TV. Forth, educational compulsion such as “you have to do that.” was mainly used as Environmental guidance for sound attitude in school without clear reasons. In the last analysis, hindrance factors of sound management for environmental education in elementary schools were ‘passive adjustment’, ‘discriminative reception’, ‘absence of information resource’. these factors came from atmosphere of negligence environmental education in schools. Therefore, all of teachers have to affirmative belief and attitude as personal dimension and all of elementary schools improve environmental education system.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.9-15
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• 2006

Work-related musculoskeletal disorder has been associated with long hours of computer work and prolonged periods of static posture. In clinical settings, postural correction is a common treatment approach for individuals with neck, shoulder, and back pain. This study was designed to identify the effect of Forward Head Posture Correctional Device during computer work. Twelve healthy adults (mean age, 27.4 yrs; mean height, 165.0cm mean weight, 65.8 kg) participated in the study. They had no medical history of neurological or surgical problems with their upper extremity. The subjects were asked to perform Head Forward Posture under the guidance of physical therapists and the measured angles were analyzed using a 3-D motion analysis system. Markers were placed on the C7 spinous process, tragus of the ear and forward head angle was between the line from the tragus to the C7 line and the Y-axis at the C7. The statistical significance of difference between, "without" and "with" correctional device was tested by paired t-test. A level of significance was set at ${\alpha}$=.05. In comparison of the computer work between "without" and "with" correctional device, Forward Head Angle was showed significant difference (p<.05). In conclusion, the range of Forward Head Angle was significantly decreased during computer work with the correctional device. Further research is needed to understand the nature of motor control problems in deep muscles in patients with neck, shoulder, and back pain.

• 지역사회간호학회지
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• 제12권1호
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• pp.32-38
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• 2001

This study focused on the understanding the life of the elderly in the institution by phenomenological method. The participants were seven. who were 4 men and 3 women living in the elderly institution in Taegu. The data were collected through the indepth interviews and participant observation from June 20. 1999 to January 10. 2000 and analyzed by phenomenological analytic method by Giorgi. The structure of the meaning were as follows: Unhappy life: irresponsibility. self-centered thought. hardness. Irresistible life: misfortune. unhealthiness. Reading their son's intention. Bitter life: unfair treatment from their sons and daughters, betrayed feeling for their being thrown away. Outside oriented life: a fear of others' attention, wrong information about institutionalized life, maladjustment. Self-consolation life: comfortableness, convenience, economic merit of low cost. Dissatisfied life: discomfort from communal living. unkindness of the institution staffs, depreciated tendency to the elder people, irrational social security system. economic distress, physical pain, restrained feeling. Tenacity to their sons and daughters longingness for their sons and daughters, regretableness, waiting, Regretable life: remorse for their past life. agony, guilty, loneliness, grief, self-abandonment, self-depreciation, other residents' death in common. Inharmonious life with other residents complaint, conflict, ignorance, selfishness. Yearning life for opposite sex: sexual interest. Preparing for their life: control over their body and mind, consideration for others. A life with hope: blessing death, forever healthfulness, affiliation to their family. From the results of this study an education and consultation should be done as soon as possible to remove the negative recognition of the institutional life to the facility residents. the family and the future consumers of elderly institution. To minimize the maladjustment to facility life of residents, a new program and interventions for the new comer's are needed. The thesis with above results will widen the understandings of institutional residents and an important guidance for a better nursing care in elderly institutions of korea.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.526-537
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• 2023

Hepatitis C virus (HCV) infection is a major health problem worldwide and its eradication is mandatory. Direct acting HCV polymerase inhibitors, such as Sofosbuvir (SOF), is an effective regimen. However, it has some side effects like mutagenesis, carcinogenesis, and the impairment of testicular function. It is important to evaluate the safety of SOF on the ovary, as there are no studies yet. Increasing the production of Reactive Oxygen Species (ROS), causes oxidative stress, which affects ovulation process, female reproduction, and fertility. Accumulation of SOF in the cells was demonstrated to promote ROS generation. Vitamin E (Vit E) is an antioxidant agent that has an essential role in the female reproductive system, its deficiency can cause infertility. We explored the effect of SOF treatment alone and co-treated with Vit E on ovarian ROS level and ovarian morphology experimentally using biochemical and immunohistochemical studies. Significant changes in oxidative stress markers; nitric oxide and malondialdehyde lipid peroxidation, antioxidant enzymes; catalase, super oxide dismutase, and reduced glutathione, proliferating markers; proliferation cell nuclear antigen and Ki-67 antigen and caspase 3 apoptotic marker were demonstrated. It was shown that where SOF induced oxidative stress, it also aggravated ovarian dysfunction. The essential role of Vit E as an antioxidant agent in protecting the ovarian tissue from the effect of oxidative stress markers and preserving its function was also displayed. This could be guidance to add Vit E supplements to SOF regimens to limit its injurious effect on ovarian function.

• 대한소아치과학회지
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• 제36권3호
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• pp.456-463
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• 2009

쇄골두개 이형성증(Cleidocranial Dysplasia)은 안면, 두개골, 쇄골의 비정상적인 성장을 보이는 증후군으로 상염색체 우성으로 유전되거나 유전적 요인 없이 돌연변이에 의해 야기된다. 쇄골두개 이형성증의 일반적 소견은 두개 봉합과 천문의 지연 폐쇄, 편측이나 양측성으로 쇄골의 형성 장애, 상대적으로 커진 이마에 의해 상악골이 함몰된 것처럼 보이는 안면 형태가 특징적이다. 구강내 소견으로는 유치의 만기 잔존, 그로 인한 영구치의 맹출 지연을 보이며 방사선 사진 상에서 매복된 다수의 과잉치가 존재한다. 쇄골두개 이형성증은 정신적 및 신체적으로 특별한 이상을 나타내지 않아 진단이 늦어지는 경우가 많아 영구치의 미맹출로 인하여 저작 및 심리적인 문제가 초래되는 경우가 많다. 따라서 조기 진단을 통해 적절한 시기에 유치 발치 및 과잉치 제거 후 교정적 처치로 영구치의 맹출을 유도하여 저작 기능의 회복뿐 아니라 환자의 안모도 개선시켜야 한다. 본 증례는 영구치 맹출 장애와 전치부 반대교합을 주소로 내원하여 쇄골두개 이형성증으로 진단받은 환아들의 구강내 증상과 치아 맹출 유도법을 통하여 치아를 맹출시킬 수 있었기에 보고하는 바이다.

• Molecules and Cells
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• 제38권3호
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• pp.221-228
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• 2015

Because Schwann cells perform the triple tasks of myelination, axon guidance and neurotrophin synthesis, they are candidates for cell transplantation that might cure some types of nervous-system degenerative diseases or injuries. However, Schwann cells are difficult to obtain. As another option, ectomesenchymal stem cells (EMSCs) can be easily harvested from the nasal respiratory mucosa. Whether fibrin, an important transplantation vehicle, can improve the differentiation of EMSCs into Schwann-like cells (SLCs) deserves further research. EMSCs were isolated from rat nasal respiratory mucosa and were purified using anti-CD133 magnetic cell sorting. The purified cells strongly expressed HNK-1, nestin, $p75^{NTR}$, S-100, and vimentin. Using nuclear staining, the MTT assay and Western blotting analysis of the expression of cell-cycle markers, the proliferation rate of EMSCs on a fibrin matrix was found to be significantly higher than that of cells grown on a plastic surface but insignificantly lower than that of cells grown on fibronectin. Additionally, the EMSCs grown on the fibrin matrix expressed myelination-related molecules, including myelin basic protein (MBP), 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) and galactocerebrosides (GalCer), more strongly than did those grown on fibronectin or a plastic surface. Furthermore, the EMSCs grown on the fibrin matrix synthesized more neurotrophins compared with those grown on fibronectin or a plastic surface. The expression level of integrin in EMSCs grown on fibrin was similar to that of cells grown on fibronectin but was higher than that of cells grown on a plastic surface. These results demonstrated that fibrin not only promoted EMSC proliferation but also the differentiation of EMSCs into the SLCs. Our findings suggested that fibrin has great promise as a cell transplantation vehicle for the treatment of some types of nervous system diseases or injuries.

• 한국콘텐츠학회논문지
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• 제15권1호
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• pp.357-365
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• 2015

민간요법 유해사례란 예로부터 민간에 전해 내려오는 질병 치료법인 민간요법 사용 중에 발생되는 바람직하지 않거나 의도되지 않은 모든 불편감이다. 본 연구는 인터넷 뉴스기사를 통해 민간요법 유해사례의 형태와 위험성을 분석하고자 하였다. 인터넷트렌드(www.internettrend.co.kr)의 웹사이트 분석평가에 의한 점유율 상위 3개 포털 사이트인 네이버(NAVER), 다음(DAUM), 네이트(NATE)를 검색 대상으로 선정하여 최근 5년간(2009년 1월 1일부터 2014년 2월 28일까지) 민간요법 유해사례의 신문기사를 검색하였다. 총 973건의 신문기사가 검색되었고 18건이 포함기준에 만족되었다. 유해사례를 경험한 사람은 총 27명으로 연령은 4개월부터 76세까지이고, 남녀 모두에게 발생하였다. 2회 이상 반복적인 유해사례를 일으킨 민간요법으로는 독성 약재인 봉삼 또는 초오를 재료로 사용하여 복용한 요법, 피부에 외용하는 식초요법, 시술자에 의한 벌침 또는 부항요법이었다. 중대한 유해사례로서 사망이 11명이 있었으며 자신이 직접 복용한 1명을 제외하고는 모두 의료인이 아닌 무자격자의 시술에 의한 사망이었다. 국내에서 대중적인 민간요법은 인터넷 상에서 정보가 활발히 상호 교류되며 전문 의료인의 지도 없이 오, 남용되고 있는 것이 현실이다. 국민의 보건의료측면에서 국가나 의료계가 민간요법 유해사례에 대한 위험성 홍보 및 올바른 건강정보 제공 계획을 세우고 나아가 유해사례를 보고 및 감시하는 체계도 확립해야 할 필요성이 있음을 지적하는 바이다.

• 무역상무연구
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• 제69권
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• pp.589-616
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• 2016

The reviewing of an analysis of the Korea-China FTA due to guidance introduced for the new regulations or exceptional regulations compared to the KORUS, Korea-EU, Korea-ASEAN FTA. Commodity sectors in the Korea-China FTA and the KORUS, Korea-EU, Korea-ASEAN FTA(the majority in the country and trade criteria analysis result) compared and analyzed the results, rules of origin and the customs clearance procedures of origin, preferential tariff rate of origin and the origin preferential specific rules are somewhat difference, but customs and trade facilitation regulations are already quite consistent with the Korea customs system. Relatively important research results were as follows. First, the calculation of the regional value content in KORCHINA FTA is that I'm to use the deduction method can comprehensively reflect a regional value ratio, with respect to the materials acquired originating status as the FTA in the US and EU use the product non it's not to consider the value of the originating materials originating materials can be utilized for intermediate goods. Second, even if a non-treaty country in the middle with the exception of direct transport rules, and acknowledge the country of origin are under customs control, there are provisions for the period are temporarily stored in a non-treaty countries separately, that period goods imported into the non-treaty countries and up to three months from the day. If the situation of the occurrence of force majeure be greater than three months, but has so exceed six months. Third, the materials acquired originating status in the Korea-China FTA not to consider the value of non-originating materials used in its products as the KORUS FTA and Korea-EU FTA, that can be utilized originating materials for intermediate goods. It is expected that higher utilization of rules of origin. Meanwhile, Korea-China FTA has provisions to allow requests for preferential tariff applied on imports Customs declaration of intention to apply pre-condition for a preferential tariff applied to the importer. In other words, if the import customs tariff preference when applying post-intention not to advance is to be noted that any preferential treatment to prevent the later application.