• Journal of Gastric Cancer
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• v.5 no.2
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• pp.79-88
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• 2005

Quality assurance may be defined as the complete set of systemic actions that is required to achieve a better treatment result by standardizing treatment and by using various audit programs. In general, application of a quality assurance program in surgery is considered to be more difficult than it is in chemotherapy or radiotherapy. However, recently, the importance of quality assurance in the surgical field has been emphasized in clinical trials comparing different surgical procedures and evaluating the role of postoperative adjuvant therapy. In the case of gastric cancer surgery, excellent quality assurance programs have rarely been applied in most large prospective clinical trials. Although the quality assurance in Dutch trial was conducted very systemically and strictly, the situation is quite different from ours. On the other hand, several quality assurance programs in Japanese trials comparing D2 and D2 plus para-arotic lymph node dissection seem to be applicable to Korean clinical trials. Several factors, including selection of appropriate surgeons based on personal experience and annual number of operations, standardization of surgical procedures by education and consensus, development of a unified database program, application of standardized perioperative management, and standardization of pathologic examination, are required to guarantee a successful multi-institutional prospective clinical trial. In contrast, one needs to realize that protocols that are too strict and sophisticated can make the enrollment of patients and surgeons more difficult and can promote protocol violation during the clinical trials. (J Korean Gastric Cancer Assoc 2005;5:79-88)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.2
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• pp.169-174
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• 2000

Purpose: Previously reported ocular complications of interferon alfa administration are extremely rare. We experienced a 15-year-old boy with chronic hepatitis B who developed glaucoma after interferon alfa therapy. The purpose of this prospective study was to evaluate the possible development of glaucoma after interferon alfa therapy for chronic hepatitis B. Methods: Nine patients with chronic hepatitis B who visited Inha university hospital between February 1998 and July 1999 received interferon alfa therapy. We measured visual acuity, intraocular pressure, C/D ratio, and visual field examination at pre-interferon therapy, three and six months after therapy, respectively. Results: The total number of patients was 9 (4 boys and 5 girls). Mean age was $11.7{\pm}4.1$ years. The duration of therapy was 6 months and mean dosage of interferon was 5 million units. Compared with visual acuity, intraocular pressure, and C/D ratio at pre-therapy, those parameters at 3 months and 6 months after therapy showed no significant differences and none showed visual field defect after therapy. Conclusion: Our prospective study showed no evidence of development of glaucoma after interferon therapy. However, it is necessary to be concerned about the possibility of developing glaucoma or other ophthalmologic diseases after interferon therapy in chronic hepatitis B.

• Korean Journal of Childcare and Education
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• v.5 no.1
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• pp.41-57
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• 2009

This study investigated the teaching practice of students attending a three-year early childhood education course in K City, Gyeonggi Province, as well as the educational environments of 72 kindergartens and child care centers where they received field training and which were located in Gangseo-gu, Seoul, Incheon Metropolitan City, Bucheon, and Ilsan. After four weeks of teaching practice, those prospective teachers were surveyed for their objective opinions and current state regarding the practice guidance for students, teachers' working hours and wages, and female dominance in number among early childhood educators and heads of early childhood education institutions. Those data were collected to understand the operations of early childhood education institutions and the current teaching practice. According to the analysis results, the students of the early childhood education major said the four-week teaching practice was very helpful for them to understand the field and thus had positive receptions of it. Most of the prospective teachers felt the heaviest burden and experienced the biggest shortcomings in practical skills such as music, art, and hand play during class. They also felt a partial need for male counterparts. Those findings will help prospective teachers understand the field further before going out on the field and the teaching bodies have specific ideas about what kind of guidance is provided by kindergartens or child care centers. In addition, they will hopefully serve as basic data to form organic connections between the educational institutions and the field to produce more talented early childhood education teachers.

• Journal of Gastric Cancer
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• v.18 no.1
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• pp.30-36
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• 2018

Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.

• Journal of Korean Neurosurgical Society
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• v.44 no.1
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• pp.26-35
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• 2008

Objective : In the evaluation of patients with Parkinson's disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol. Methods : Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery. Results : All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer's guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations. Conclusion : Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients' comfort and improve the clinical symptoms in harmony with STN stimulation.

• The korean journal of orthodontics
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• v.35 no.5 s.112
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• pp.381-387
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• 2005

The aim of this study was to compare the clinical performance of 4 types of orthodontic wires, indicated for initial tooth alignment: stainless steel, multistranded steel, superelastic and thermoactivated nickel-titanium. A prospective randomized clinical trial was conducted on a sample of 45 patients, at the Dental School of the State University of Rio do Janeiro, Brazil. Fixed appliances were fitted and study casts were obtained from each patient. Randomly, the wires were allocated as follows: 26 dental arches for superelastic NiTi wires, 22 for stainless steel, 22 for multistranded and 20 for thermoactivated archwires. After 8 weeks, the archwires were removed and impressions for study casts were taken again. Using a 3D digitization technique of defined anatomical points on the study cast crowns, a Dental Irregularity Index (DII) was created for each study cast. The difference between DII before and after the archwire insertion expressed the aligning effect of the wires. ANOVA tests were employed to evaluate the anatomical point approximation (positive DII) and separation (negative DII), for each area of the dental arches: upper and lower whole arch and anterior arch. Results showed no significant difference between the different archwires.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.183-192
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• 2000

Purpose : Adverse events(AE) associated with vaccination have not been systematically monitored in Korea. But since 1994, several deaths after inactivated mouse brain derived Japanese encephalitis vaccine injection arouse the safety problem of immunization in the public, and a evaluation of vaccination program including the effectiveness and safety problem had been started. We have been using MMR vaccine containing Japanese mumps vaccine strains, which are known to be associated with the high rate of adverse events including aseptic meningitis, for the last decade. Methods : We conducted a prospective study of vaccine adverse events associated with MMR vaccine through a tracking system using telephone calls. We followed up 7,594 cases of MMR vaccinees. Results : Reported adverse events included fever, couvulsion, parotitis, and aseptic meningitis. Nine cases of parotitis and seven cases of aseptic meningitis were recognized during follow up period. The incidence of both parotitis and aeptic meningitis was $85.1/10^5$, for Urabe mumps strain. For Hoshino strain, the incidence of parotitis and aseptic meningitis was $158.0/10^5$ and $94.8/10^5$, respectively. Conclusions : The incidence of adverse events was to be a higher than that of natural infection in Korea and was comparable to the results of studies done in other countries.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.2
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• pp.151-165
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• 1997

A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

• Korean Journal of Childcare and Education
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• v.10 no.6
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• pp.165-184
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• 2014

The purpose of this study is to examine the effect of SNS use by prospective early childhood teachers in PBL class on flow and problem-solving skills. For this purpose, the PBL class was conducted for eight weeks with 44 prospective students in the early childhood social studies course, and measured the classroom situation in terms of usefulness of SNS, flow, and problem-solving skills by using a cognitive test. To analyze the measured values, frequency analysis, reliability analysis, factor analysis, and correlation analysis were performed. Also, to verify the hypotheses set in this study, structural equation modeling was used based on AMOS. The result is as follows: First, in PBL-based class, use of SNS had a positive effect on flow. Second, flow had a direct influence on problem-solving skills. Third, however, use of SNS did not have a direct influence on problem-solving skills and, therefore, flow plays a mediating role for problem-solving skills. Based on the result, in the study, it was found that the use of SNS in PBL class can increase interest, motivation, and participation of students and they then become more willing to contribute to class activities.

• Korean Journal of Digital Imaging in Medicine
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• v.10 no.1
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• pp.45-50
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• 2008

Recently, MR Cholangiography used mainly bu controlling of patient's breathing. There is breathing hold techniques to get images within shopt time and gating technique adjusted to respiration cycle for high resolution image. In this study, the aim of this experiment is to know on clinical usefulness compared with PACE and RTG thchniques. This study's period is from 2006 in November to 2007 in January. A total of 21 patients investigated at MAGNETOM Sonata 1.5T (SIEMENS Erlangen) with use of 12ch body coil. MR acquisition protocol used 3D turbo spin echo coronal sequence. Scan parameters applied to potimal setting in use as gating techniques, respectively. Analysis of consuming timing evaluated with rapidness. As analysis of quantity, the common bile duct, gall bladder measured in signal intensities, then these data were calculated by signal to noise ratio and contrast to noise ratio. Qualitative analysis, experienced 2radiologists and 3 RTs were evaluated into 3groups about artifact, accuracy of lesions, sharpness of the common bile duct or gall bladder. As a result of analysis, when compared to PACE, consuming time of the RTG took less than PACE, On both CNRs and SNRs, PACE technique was slightly high values than RTG(p<0.05). Qualitative analysis' results, discrimination of lesions in the common bile duct, gall bladder get a significance level in both RTG and PACE techniques but presence's artifact of breathing and pulsation highly demonstrate in PACE techniques. In conclusion, both PACE and RTG methods at MRCP provided prominently clinical information for the common bile duct, gall bladder. If machines have not limitation with performance, induction of breathing holding also will help getting diagnistic quality.