• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.75-82
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• 2024

Purpose: As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022. This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city. Methods: In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed. Results: A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics. Conclusions: This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1658-1670
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• 2021

Objective: To assess the two-year treatment outcomes of chemoembolization with drug-eluting embolics (DEE) for nodular hepatocellular carcinoma (HCC). Materials and Methods: This study was a prospective, multicenter, registry-based, single-arm trial conducted at five university hospitals in Korea. Patients were recruited between May 2011 and April 2013, with a target population of 200. A DC Bead loaded with doxorubicin was used as the DEE agent. Patients were followed up for two years. Per-patient and per-lesion tumor response analysis, per-patient overall survival (OS) and progression-free survival (PFS) analysis, and per-lesion tumor control analysis were performed. Results: The final study population included 152 patients, with 207 target lesions for the per-lesion analysis. At one-month, six-month, one-year, and two-year per-patient assessments, complete response (CR) rates were 40.1%, 43.0%, 33.3%, and 19.6%, respectively. The objective response (OR) rates were 91.4%, 55.4%, 35.1%, and 19.6%, respectively. The cumulative two-year OS rate was 79.7%. The cumulative two-year PFS rate was 22.4% and the median survival was 9.3 months. In multivariable analysis, the Child-Pugh score (p = 0.019) was an independent predictor of OS, and tumor multiplicity (p < 0.001), tumor size (p = 0.020), and Child-Pugh score (p = 0.006) were independent predictors of PFS. In per-lesion analysis, one-month, six-month, one-year and two-year CR rates were 57.5%, 58.5%, 45.2%, and 33.3%, respectively, and the OR rates were 84.1%, 65.2%, 46.6%, and 33.3%, respectively. The cumulative two-year per-lesion tumor control rate was 36.2%, and the median time was 14.1 months. The Child-Pugh score (p < 0.001) was the only independent predictor of tumor control. Serious adverse events were reported in 11 patients (7.2%). Conclusion: DEE chemoembolization for nodular HCCs in the Korean population showed acceptable survival, tumor response, and safety profiles after a two-year follow-up. Good liver function (Child-Pugh score A5) was a key predictor of per-patient OS, PFS, and per-lesion tumor control.

• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• Journal of The Korean Association For Science Education
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• v.29 no.2
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• pp.137-155
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• 2009

The purpose of the present study was to analyse the effectiveness of a gifted education program. To analyse the effectiveness of an education program for the gifted affiliated with a university, the study carried out a quasi-experimental design to compare the 153 gifted students who enrolled in an education center for the gifted and the 131 potentially gifted students who were nominated by teachers for their high achievements and interests in science but without any education services for the gifted. These two groups of students were compared in the aspects of problem finding ability in science, motivation, self regulation, science-related attitudes, and science anxiety through the pre- and post-treatment settings. The results indicated that the gifted group showed a significant improvement in originality and elaboration of problem-finding ability, but the potentially gifted group showed significant decrease in most variables of problem finding. Related to motivation and self-regulated learning, gifted students showed an increase in cognitive strategy use and decrease in intrinsic value, but the potentially gifted students showed significant decreases in most variables related to motivation and self-regulation, except intrinsic value. Related to the scientific attitudes and science anxiety, there were no significant changes between pre- and post-tests in the gifted group, but significant decreases in most variables were found in the potentially gifted group. The results of paired t-test and Ancova indicate that significant differences between the gifted and the potentially gifted groups are mainly due to the significantly lowered performance in post tests in the potentially gifted group, rather than a significant increase in gifted group.

• Journal of The Korean Association For Science Education
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• v.29 no.2
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• pp.179-192
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• 2009

The purpose of this study was to examine the effects of Small-Scale Chemistry (below SSC) Lab Program with respect to students' extroversions and introversions. For this study, an SSC Lab Program was developed on the basis of analyzing the chemistry part of the high school science textbook in the 7th curriculum. The experimental group received SSC experiment lessons, and the comparison group received traditional experiment lessons based on textbook for 5 class periods. Afterwards, students were grouped into extrovert and introvert according to their personality test scores, the differences between the two groups were investigated using 2-way ANCOVA. Prior to the instructions, three test regarding the scientific attitude and academic self-efficacy were administered. After the instructions, the scientific attitude, academic self-efficacy, and students' perceptions on SSC Lab Program were examined. The scores in mid-term and end-of-term science exams were used as pre-test and post-test science achievement scores, respectively. Two-way ANCOVA results revealed that there were effects in the score of the academic achievement score, but there was no interactive effect between extroversion/introversion and treatment. In addition, a significant interactive effect was found in the scientific attitude, but there was no significant main effect. It was interpreted that extrovert students had many opportunities in SSC experiment classes and were able to experiment with initiative, but introverts would feel the responsibility and the pressure owing to the small group experiment. There were no main and interactive effects in the score of the academic self-efficacy test. Survey of students' perceptions on SSC Lab Program revealed that both over 90% extrovert and introvert students showed very positive perceptions in 'three-membered small group composition,' 'understanding,' and 'convenience' items. It was found to be a very different perception between extrovert and introvert students in 'comparing result with other students' item.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.59-104
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• 2023

This essay attempts to analyze the public health welfare conception within the text of the Beveridge Report and its realization via the NHS in Great Britain. Once referring to the influence of the Report to create the foundations of the 20th-century welfare system, the quest to scrutinize the original intentions of the Report and its succession to the NHS is certainly intriguing. Furthermore, when regarding the significance of public health policy for a modern state, the effort to engage in Beveridge's conception and its realization is more than timely. In light of such a premise, this paper indulges in its study by the following methods. First, the historical background of the Report - namely, the role of the spirit of the age and the experience of the Emergency Medical Service are to be analyzed to identify the origins of the welfare policies proposed by Beveridge. Furthermore, the public health welfare conception of the Report conceived from its time is reflected upon by engaging on the goal towards social welfare and public health scheme. Lastly, the aims of the NHS and its management, treatment classification, and rehabilitation program are reviewed for comparative analysis with the Report to survey the realization of Beveridge's design. In this process, this paper not only takes into account the original text of the Report - but also other essential works of law and public policy, including the NHS Constitution for England and the National Health Service Act of 1946. The intentions of this study are not bound by merely coinciding with the Report, but resonate significance via reflecting upon the Beveridgian legacy on the modern welfare state from the current perspective. The structured analysis to research the aims and policies of the Report and to compare them to the reality of the NHS may provide an opportunity to confirm the realization of Beveridge's scheme in British society. In addition, this essay is part of an academic endeavor to critically assess the past and the present of the welfare institution in the public health sector. As such, it is hopeful that the essay sheds light on further studies concerning the constructive remedies of the Korean welfare system as well.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.129-139
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• 2023

Background: The elderly population aged 65 or older in Korea is expected to continue to increase to 18.4% in 2023, and to enter a super-aged society at 20.6% in 2025. In clinical practice, the elderly discrimination of dental hygienists may experience difficulties during dental hygiene treatment due to an increase in the number of elderly patients due to aging, which can lead to maladjustment to work and turnover, so education on the understanding of the elderly is essential for students in the Department of Dentistry, who are prospective dental hygienists. Accordingly, a study was conducted to prepare for a super-aged society by studying the relationship between elderly discrimination and the knowledge and attitudes of the elderly, and to change the curriculum of universities and develop programs related to the elderly. Method: 204 students enrolled in the Department of Dentistry in D area were analyzed using the SPSS/WIN 25.0 program. The subject's geriatric discrimination, knowledge about the elderly, and attitude toward the elderly were calculated as the mean and standard deviation. T-test and one-way ANOVA were performed to verify the difference in geriatric discrimination according to the general characteristics of the subject, with a Scheffe' test applied for post-hoc analysis. Correlation analysis was conducted on the subject's geriatric discrimination, knowledge about the elderly, and attitudes toward the elderly. Results: Geriatrics scored 2.03±0.36 out of 4. Knowledge about the elderly was categorized as follows: physical domain 0.57±0.15; social domain 0.36±0.17; and psychological domain 0.35±0.20. The attitude toward the elderly was 3.86±0.27. Knowledge of the elderly averaged 11.27±3.30 points out of 25. The question with the highest percentage of correct answers to knowledge about the elderly was 'physical strength tends to decrease with age', which was 93.1%. The attitude toward the elderly according to the general characteristics of the study subjects showed significant differences in gender (p=0.040), age (p=0.026), and life experience with grandparents (p=0.001). The elderly discrimination of the study subjects showed a negative correlation in both attitude and knowledge toward the elderly, and among the elderly discrimination, there was a high positive correlation with regard to emotional avoidance (r=.892, p<0.001). Conclusion: College students are the leading players in caring for the elderly and are directly affected by aging social problems. Therefore, it is considered necessary to apply various programs in the state, society, and educational institutions to avoid negative prejudices that lead to positive thinking and discrimination against the elderly.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.403-414
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• 2023

Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

• Animal Bioscience
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• v.37 no.8
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• pp.1495-1502
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• 2024

Objective: This research investigated the effect of administering chromium (Cr) and meloxicam (MEL) on growth performance, cortisol and blood metabolite, and behaviors in young, regrouped heifers. Methods: Fifty Holstein dairy heifers (body weight [BW] 198±32.7 kg and 6.5±0.82 months of age) were randomly assigned to non-regrouped group or four regrouped groups. Non-regrouped animals were held in the same pen throughout the entire experimental period (NL: non-regrouping and administration of lactose monohydrate [LM; placebo]). For regrouping groups, two or three heifers maintained in four different pens for 2 weeks were regrouped into a new pen and assigned to one of four groups: regrouping and LM administration (RL); regrouping and Cr administration (RC); regrouping and MEL administration (RM), and regrouping and Cr and MEL administration (RCM). LM (1 mg/kg BW), Cr (0.5 mg Cr picolinate/kg dry matter intake), and MEL (1 mg/kg BW) were orally administered immediately before regrouping. Blood was collected before regrouping (0 h) and at 3, 9, and 24 h and 7 and 14 d thereafter. Behaviors were recorded for 7 consecutive days after regrouping. Results: Average daily gain was lower (p<0.05) in RL than NL heifers, but was higher (p<0.05) in RM, RC, and RCM than RL heifers. RL heifers had higher (p<0.05) cortisol than NL heifers on d 1 after regrouping. The cortisol concentrations in RC, RM, and RCM groups were lower (p<0.05) than in RL treatment 1 d after regrouping. Displacement behavior was greater (p<0.05) in RL group than all other groups at 2, 3, and 6 d after regrouping. Conclusion: Regrouping caused temporal stress, reduced growth performance, and increased displacement behavior in heifers. Administering Cr and MEL recovered the retarded growth rate and reduced displacement behavior, thereby alleviating regrouping stress.