• Archives of Plastic Surgery
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• v.35 no.1
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• pp.86-91
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• 2008

Purpose: The performance of rhinoplasty on the patient who has already undergone unsatisfactory results or complications after augmentation rhinoplasty is a challenging surgical problem. Because the dead space is remained after removal of the foreign body and the thickness of the skin is not even, the deformity would be more conspicuous if the nose is reconstructed again with hard implant only or autogenous cartilage. In these cases, the autogenous fascia can be used to get a good result. We present our clinical experience of secondary rhinoplasty using Scarpa's fascia of lower abdomen. Methods: Thirty-two patients underwent the procedure from March of 2002 to February of 2007. Nine patients were reconstructed with Scarpa's fascia only, eighteen patients were reconstructed with silicone implant and fascia, and five patients were reconstructed with cartilage and fascia for secondary rhinoplasty. Results: There were no major complications. Most of the patients were satisfied with the results. The deviation of the silicone implant and postoperative hypertrophic scar of the donor site were seen in one case each. Postoperative absorption of fascia were seen in two cases using Scarpa's fascia only. Conclusion: Secondary rhinoplasty using Scarpa's fascia is very useful method which offers a minimized donor site scar, low complication rate, shorter operation time and patient satisfaction and prevents the alopecia caused by the harvest of temporalis fascia.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.520-528
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• 2014

Background As the breast cancer incidence has increased, breast-conserving surgery has replaced total mastectomy as the predominant procedure. However, centrally located breast cancers pose significant challenges to successful breast-conserving surgeries. Therefore, we performed partial mastectomy and oncoplastic procedures on centrally located breast cancer as a means of partial breast reconstruction. The authors examined and evaluated the functional and aesthetic usefulness of this reconstruction method. Methods From January 2007 to June 2011, 35 patients with centrally located breast cancers who underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques such as purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic procedures included volume replacement procedures with an adipofascial, thoracoepigastric, intercostal artery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results Mean patient age was 49 years, and mean follow-up period was 11 months. In cases of small to moderate-sized breasts and resection volumes <50 g, volume displacement procedures were performed. In cases of resection volumes >50 g, volume replacement procedures were performed. In cases of larger breasts and smaller resection volumes, glandular reshaping was performed. Finally, in cases of larger breasts and larger resection volumes, reduction mammaplasty was performed. This reconstruction method also elicits a high patient satisfaction rate with no significant complications. Conclusions In centrally located breast cancer, oncoplastic surgery considering breast size and resection volume is safe and provides appropriate aesthetic outcomes. Therefore, our method is advisable for breast cancer patients who elect to conserve their breasts and retain a natural breast shape.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.81-86
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• 1999

Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.

• Journal of Korean Physical Therapy Science
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• v.21 no.1
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• pp.1-12
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• 2014

Purpose : This study aims to provide fundamental information for increasing a physical therapist's empowerment and suggesting effective ways to incorporate humor into the physical therapist's organizations by investigating a level of perceived sense of humor and empowerment, as well as examining the relationship between them. Method : This study was conducted in the country's 9 general hospitals, 11 rehabilitation hospitals, 20 clinics. The data of general characteristics, sense of humor, and empowerment were collected from 1 August 2012 to 25 August 2012. A total of 300 clinical instructors were distributed and collected. The call response rate was 94.7%(n=284). The collected data were analyzed by spss/pc + 12.0 Result : 1. The mean score of the physical therapist's sense of humor was $56.53{\pm}05.58$ out of 84 and each of the sub-dimensions were scored in order of emotional expressiveness, liking of humor and metamessage sensitivity. 2. The mean score of the physical therapist's empowerment was $56.67{\pm}12.72$ out of 84 and each of the sub-dimensions scored in order of meaning, competence, self-determination and impact. 3. There was no significant difference between the sense of humor and the empowerment(r=0.093, p=0.118). 4. There were no significant difference in sense of humor. 5. There were significant differences in the levels of the empowerment by sex, marriage, workers satisfaction, age, attainment in scholarship, workplace, and duration of work. Conclusion : Although there was no significant difference between the sense of humor and the empowerment. the sub-dimension of human preference was significant.

• Journal of the Korean Society of Clothing and Textiles
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• v.27 no.9_10
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• pp.1081-1092
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• 2003

The purpose of this study was to identify the current situation of textiles and apparel firms in the overseas markets and to examine the relationship between firms' characteristic(i.e., sales volume) and international marketing strategies. A random sample of 311 textiles and apparel firms were selected. The survey design method was used to test conceptual framework. Adjusted response rate was 33.4%(n=115). Descriptive analysis (i.e., frequency, percent) and $\chi$$^2$-test were used for data analysis. About the current situation of textiles and apparel firms in the overseas markets, the motivation for international market entry was highly found to expand their operation from domestic to international market, and most firms were found to be involved with OEMs(Original Equipment Manufacturers) as an entry mode for international market. China and US market were the most popular market among Korean textiles and apparel firms. Product differentiation strategy, pricing strategy based on manufacturing cost and buyer's offering price, place strategy using foreign buyers and participating a few international exhibition were frequently used among Korean textiles and apparel firms for international marketing. Among textile firms, sales volume was related to product strategies(product development), price strategy(buyer's offer) and place strategy(channel). Among apparel firms, product strategy(product labeling), price strategy(price satisfaction). The findings of this can be used when Korean textiles and apparel firms do strategic planning and evaluate the international marketing strategies. Also information and results of this study may assist policy makers to develop better ideas and strategies for textiles and apparel industry.

• The Korean Journal of Food And Nutrition
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• v.4 no.1
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• pp.45-60
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• 1991

This survey was carried out to Investigate the effects of dietary attitude on the nutrition knowledge, food habits, the daily average nutrient Intakes and the intake of Instant food, convenience food & fast food between college women and their mothers. Questionnaires were completed by 214 college nutrition majors and also by their mothers numbering at 173. College women's mothers showed a better average in meal time regularities per week than that of. college women. Also it is the fact that the college women had a higher frequency rate of instant food and fast food than their mothers. In the case of both college women and mothers if they eat at regular meal times they had a higher score in food habits. But the daily average nutrient intakes was not significant because of the fact that the meal time regularity and nutrient intakes 414 not concise. The higher frequency of instant food intake had a lower score in food habits and nutrition knowledge. The higher frequency of fast food Intake had a higher food habits score but it also had a lower score in nutrition knowledge. As in the intake of instant food and convenience food the college women had a higher Intake frequency. In the dietary pattern the college women they liked to eat (lour foods. But their mothers liked to eat Korean foods. The selective motive and the degree of satisfaction of food service industry product was for convenience and time saving. The food service industry products were found to be unsatisfactory in nutrition and sanitation. Therefore we must be more aware of preventing the disappearance of Korean traditional foods. For the continuing development of our dietary culture we need to have the food service industry to develop more suitable diet for Korean.

• Health Policy and Management
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• v.22 no.1
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• pp.129-144
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• 2012

Purpose : The purpose of this study was to investigate the level of emotional labor and to identify affecting factors on emotional labor among one university hospital employees. Material and Method : This study was based on cross-sectional, self-administered, and Internet-based survey. The survey was conducted from Mar. 2 to Mar. 28. 2011. Total subjects were 812 employees working in one university hospital. Total response rate was 61.5%. Modified evaluation tool was used, which was originally developed by Morris and Feldman, to measure the level of emotional labor among hospital personnel. In order to identify the affecting factors on high level of emotional labor, we conducted logistic regression. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were 2-sided and a p-value<0.05 was considered statistically significant. Results : Average score of emotional labor was 3.06. Employees(3.39) who are working at the emergency department and hemodialysis room indicated the highest level of emotional labor, followed by wards(3.14), department of administration(3.14), department of ambulatory cares(3.06). The factors affecting on the high level of emotional labor were the highest level of schooling, types of department, and types of personality(p<0.05). Conclusion : The survey results showed that there was significant level of emotional labors among hospital employees. Therefore, the efforts to reduce the level of emotional labors are needed.

• Health Policy and Management
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• v.26 no.4
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• pp.373-381
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• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.

• Health Policy and Management
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• v.11 no.4
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• pp.54-69
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• 2001

This study was conducted to assess factors associated with the degree of performance of qualify improvement(QI) activities. A mailed questionnaire survey was conducted between September 15 and October 30, 2000, with the staffs being charge of QI at each of the hospitals with 400 beds or greater. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used for the analysis. Using the Malcolm Baldrige National Quality Award Criteria(MBNQAC), perceived performance of QI was measured in terms of the improvement of the quality of clinical practice, clinical supporting department, administrative procedure of receiving care, customer satisfaction, efficiency and standardization of work process. Factors evaluated for the association were the extent of QI implementation, compliance to 5 QI principles, participation of hospital CEOs, budget allocation, history of QI, and bed size. Path analysis was performed to assess the relationship between QI performance and these factors. Major findings of this study are as follows. Hospitals showing higher degree of QI implementation (path coefficient=0.5967, p<0.001)) and better compliance with the basic principes of QI(0.5736, p<0.05) tended to achieve better performance. Path analysis results showed that interest and participation of hospital CEOs(0.1954, p<0.05) and compliance with the basic principes of QI(0.4028, p<0.0001) indirectly affected the outcomes of QI by influencing the intermediate variable of the level of QI implementation. This study results suggest that having employees have a good orientation of the basic concept and principes of QI through relevant training be the most important requirement to achieve better outcomes from QI activities. In addition, to educate leaders of hospitals the need of active implementation of QI is important to encourage their participation and draw strong support for QI programs.

• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.78-99
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• 2000

Objectives: The purpose of this study was to evaluate the opinions of hospital managers on DRG pilot study. Methods: Managers of 800 hospitals which had participated in DRG pilot study during the period 1997-1999, were requested to respond to structured self-administerd questionnaire. The questionnaire was composed with six categories: the motivation and satisfaction for the DRG pilot study, the opinions on the level of unit price, the appropriateness of DRG classification, the change of medical service quality during the pilot study, the patient's complains resulted from DRG system. and the opinions on the nation-wide application of DRG system. Results : Of the 800 subjects, 327(clinic, 210: 25 hospitals, 82 general hospitals, and 16 tertiary hospitals) completed the questionnaire, and the overall response rate was 41%, 121 hospitals(27%) answered that they participated in DRG pilot study because of convenience of claims and 118 hospitals(35%) dissatisfied with DRG system. 251 hospitals(85%) thought that the level of unit price under the DRG system was same as or lower than that of fee-for service. 297 hospitals(92%) responded that DRG classification should be modified and 137 hospitals(47%) experienced deterioration of medical service quality during the DRG pilot study. The 116 hospitals(35%) experienced the patient's complains resulted from DRG system. The 85 hospitals(88%) didn't want nation-wide application of DRG system. Conclusion: Most of the responded managers seemed to have negative opinions on DRG pilot study, even though they had been participated voluntarily. Further studies and extensive evaluations of DRG reimbursement system are needed before nation-wide application.