The philtrum of the upper lip is important to the facial contour and general appearance of individuals. In patients who have undergone cleft lip surgery, reconstruction of the philtrum is important in restoring the normal appearance of the upper lip and it also helps in diverting people`s attention away from the surgical scar. Several methods of philtral dimple creation have been used, but the postoperative results have not always been satisfactory. Between 1991 and 1997, reconstruction of the philtrum with unilateral cleft nasal deformity was performed in 43 patients, transposing the orbicularis oris muscle of the central upper lip to the depressed alar base. Using this method, efforts were made to achieve reconstruction of the philtrum and correction of alar base depression simultaneously. The results were rated good to excellent by a panel of judges using the ordinary scale method. Although reconstruction of the philtral dimple and correction of the depressed alar base were very successful, reconstruction of philtral column(especially the upper portion) was not satisfactory. Therefore, other procedures such as temporal fascial grafts in the upper portion of the philtral column should also be considered at the time of primary surgery or revisional surgery.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Depression* ; Humans ; Lip ; Transplants

The nasal tip of the Asian is characterized by a bulbous appearance due to thick and tense skin. flaring of nostrils, and a short nasal tip projection due to underdevelopment of alar cartilages and retruded columella. Conventional augmentation rhinoplasty using silicone implant which has been routinely performed at the Asian nose has its limitations. Over the past 2 years, a total 33 patients, aged 19 to 47 years(mean 29 years) underwent open rhinoplasty to correct columellar retraction, to lengthen the nose and to improve the appearance of the nasal tip using columellar strut in conjunction with augmentation with silicone dorsal implant. The columellar strut for control of columellar shape is optimally constructed from 0.85 mm thickness porous polyethylene(Medpor)sheet. The columellar strut is placed between the medical crura and fixed to the caudal septum. With the strut stabilized, each medial crus is advanced to the desired position. The fixation sutures are placed at 3 points: the dormal segment of the middle crus, the junction of the middle and medial crus, and the junction of the columellar segment and the footplate segment of the medial crus of the alar cartilage. Twenty-five surface measurements based on the works of Farkas included 9 singles and 5 paired lengths, and 3 angles indirectly taken from the surface of the nasal stone model. The preoperative measurements were compared with those of the postoperative. The mean follow up period was 17 months(15-24 months). The analysis of the results was conducted using Wilcoxan matched-pairs signed-ranks test.The nose length, the nasal tip protrusion, the alar length, the alar half arc, the columellar length, the nostril length, and the alar rim-columellar length were significantly increased. The intercanthal distance, the nose width, the nostril width, and the upper lip length were significantly decreased. The nasolabial angle was also significantly increased. Good to excellent asethetic results were noted in all patient, although one patient did experience mild deviation of a columella. No extrusions occurred. Using the control columellar polyethlene strut, the retracted columella was advanced, the tip was projected, the nose was lengthened, and the nostril were narrowed and elongated. This technique is valuable in the rhinoplasty patient was has retracted columellar, short nose and long upper lip.
Asian Continental Ancestry Group ; Cartilage ; Follow-Up Studies ; Humans ; Lip ; Nose ; Polyethylene* ; Rhinoplasty ; Silicones* ; Skin ; Sutures ; Transcutaneous Electric Nerve Stimulation

A retrospective study was performed on 64 patients who underwent orbital blow-out fracture reconstruction with autogenous or Medpor implant following blunt facial trauma between 1992 and 1997. Hospital records were reviewed especially for preoperative and postoperative diplopia, enopthalmos and extraocular muscle movement limitations between the autogenous material group and Medpor implant group. The autogenous material used was mostly conchal cartilage graft. The average follow-up period was 36 months with a range of 5 to 64 months. There was no significant statistical difference between both groups on incidence of postoperative complications of diplopia, enophthalmos and extraocular muscle movement limitations. Postoperative infection, ectropion, implant extrusion and migration were absent in both groups. The use of Medpor implant for orbital blow-out fracture reconstruction was associated with a low incidence of complication. In addition, the Medpor implant is readily available, easy to use, cut, contour, position, fixate and has no potential for graft resorption, and precludes the need to harvest an autogeneous graft. In conclusion, Medpor is a stable and reliable substitute for autogeneous graft reconstruction of the orbital blow-out fracture.
Cartilage ; Diplopia ; Ectropion ; Enophthalmos ; Follow-Up Studies ; Hospital Records ; Humans ; Incidence ; Orbit* ; Orbital Fractures ; Polyethylene* ; Postoperative Complications ; Retrospective Studies ; Transplants

Osseointegrated alloplastic ear reconstruction has revolutionized ear prosthetic retention. In this report, we evaluate the results of indirect osseointegration using the Epitec system and discuss the degree of the most serious side effect of this system, the adverse skin reactions close to osseointegrated implant post. During a three year period, Osseointegrated prosthetic ear reconstruction was performed to twenty eight patients with microtia(n = 25) and traumatic ear loss(n = 3), 22 males and 6 females aged from 6 to 43 years(mean 18.2 years). The patients, including 12 children, were treated with 58 titanium implant posts of Epitec system. These were inserted into a 3-dimensional carrier-plate which were fixed to the mastoid process with 7 to 12(mean 9.2) screws. Each patient was operated in a one-stage procedure. Two months of osseointegration of the screws was followed by fabrication of the ear prostheses. All implants were stable after follow-up at 20 to 31 months(mean 24.6 months). Fifty four of the 58 implants showed no sign of skin reactions (93.1 percent: 83.3 percent for children; 100 percent for adult). Hypertrophy of soft tissue surrounding the implants were observed only in children(2 out of 12 treated children) and did not recur after subcutaneous reduction and compressive dressing.In adults, the results of the Epitec system are very satisfactory. Use of the Epitec system in children is also promising because hypertrophy of soft tissue surrounding the implants are successfully managed. In addition, the 3-dimensional carrier-plate is well osseointegrated with bone screws and stability of the carrier-plate is reinforced by osseous covering of the thin bars of the carrier-plate by appositional bone growth of the skull.
Adult ; Bone Development ; Bone Screws ; Child ; Ear* ; Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Male ; Mastoid ; Osseointegration* ; Prostheses and Implants* ; Skin ; Skull ; Titanium

PURPOSE: The purpose of this study was to identify the effects of experiences on the essential of fundamental nursing skills (EFNS) on clinical competence in nursing students. METHOD: The data was collected using a questionnaire from 233 students who completed the 2nd grade courses of nursing curricula in college. Data was analyzed using the SPSS program. RESULTS: Only 3 items of EFNS showed that over 70% of the students had performed, and 12 items showed that under 30% of the students had performed. There are significant differences with level of experiences on EFNS and the clinical competence. The regression model explained 2.4% of clinical competence. CONCLUSION: The results suggest that nursing students with higher level of experiences on EFNS will have a higher level of clinical competence. Therefore, it is necessary to develop strategies for a more effective clinical nursing education to experience more EFNSs.
Clinical Competence* ; Curriculum ; Education, Nursing ; Humans ; Nursing* ; Surveys and Questionnaires ; Students, Nursing*

Purpose: The purpose of this study was to analyze the influence of risk for post-traumatic stress disorder (PTSD risk), social stigma, and social support on the quality of life of COVID-19 survivors. Methods: Data were collected from 180 survivors who were discharged from hospital for COVID-19 from September 1 to December 31, 2021. Structured questionnaires were used to assess variables. Collected data were analyzed using SPSS/WIN 27.0, with independent t-test, one way analysis of variance, Pearson’s correlation, and hierarchial multiple regression. Results: Subjects' quality of life was correlated with PTSD risk (r=-.52, p<.001), social stigma (r=-.16, p=.029), and social support (r=.26, p=.001). The Factors influencing the quality of life were gender (β=.26, p=.001), occupation (β=-.24, p=.001), PTSD risk (β=-.48, p<.001), social support (β=.19, p=.004), and explanatory power were approximately 37% (F=14.03, p<.001). Conclusion This study found that PTSD risk in COVID-19 survivors lowered their quality of life, and social support increased their quality of life. Therefore, it is necessary to develop various intervention programs to improve the quality of life of COVID-19 survivors by reducing PTSD risk and provide a social support system.

Purpose: This study implemented an electronic medical record (EMR) training program for nursing students and aimed to confirm its effectiveness. Methods: A non-equivalent control group pretest-posttest design was used. The participants were 42 sophomore nursing students enrolled in a fundamental nursing course (experimental group: n=21, control group n=21). The EMR training program consisted of 6 sessions, taught over 5 weeks. Data were collected between April 23 and July 14, 2023, and were analyzed using the x2 test, Fisher exact test, t-test, paired t-test, Wilcoxon signed-rank test, and Mann-Whitney U test with SPSS for Windows version 24.0. Results: Significant differences were shown between the experimental and control groups regarding self-directed learning ability (t=2.22, p=.032), problem-solving ability (t=2.34, p=.026), practice satisfaction (U=136.00, p=.016) and EMR competency (U=101.50, p=.001). Conclusion The EMR training program effectively improved nursing students’ self-directed learning ability, problem-solving ability, practice satisfaction, and EMR competency. Therefore, developing and applying EMR-related content can enhance nursing student’s awareness of EMR systems is recommended.

BACKGROUND: Experiences on Objective Structured Clinical Examination(OSCE) for student assessment are limited in medical colleges in Korea. The purposes of this study were to develop an OSCE to fourth-year medical students after completion of all clerkships at Hanyang University Medical College. METHODS: The OSCE was a 8-station examination, with each station taking five minutes. We conducted two parallel OSCEs simultaneously by duplication. We checked each stage of the process in the development of OSCEs with recording of diary. We analysed validity and costs of the OSCE. We got feedback from all participants by questionnaires. RESULTS: Of the total 102 fourth-year students, only 74 persons(72.5%) were evaluated. The rate of pass was 63.5%. Cronbach alpha of the OSCE was 0.14. The scores were different between sites according to stations, especially in items related to attitude and physical. The total OSCE score was not significantly different either between duplication sites or among groups. OSCE scores didn't relate to those of both multiple choice tests and entrance exam for internship. Our use of only a few SP's contributed to relatively low cost of $85 per examinee. Both students and faculty were satisfied with the examination, and felt that the material tested was relevant and appropriate for primary care. The OSCE process served to identify weakness in the curriculum and/or teaching methods, and thus could serve as a mechanism to improve educational effectiveness. CONCLUSIONS: Problems of validity and reliability were detected in the developing process of the OSCE. It appeared financially feasible. Setting appropriate goal, optimum number of station, training of evaluators, development of good checklist, and enthusiastic support of the school's administartion were all needed more to success of such a program.
Checklist ; Curriculum ; Humans ; Internship and Residency ; Korea ; Primary Health Care ; Reproducibility of Results ; Students, Medical* ; Teaching ; Surveys and Questionnaires

Purpose: To identify the discrepancies in the textbook of fundamentals of nursing in nutrition and elimination needs in terms of number, range, definition and etc. Methods: The 10 textbooks which are the most frequently used were selected and reviewed. After then compared it with the protocols of essential nursing skills of Korean Accreditation Board of Nursing Education and evidence-based clinical nursing practice guidelines of Korean Hospital Nurses’ Association. Results: The most significant discrepancies in nutrition domain were criteria of obesity, confirmation of nasogastric tube placement. In elimination domain, there were several mixed or miss uses of French and number unit in catheter size. And appropriate catheter size for urinary catheterization and enema is different to books and guidelines. Conclusion In order to conduct an effective resource in education of nursing, textbooks need to be revised constantly and contain the recent researches and guidelines.

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.