Background: With the development of the information technology industry and the increasing importance of health information, there is a need to analyze the current certification system for health information management education. This study compared and analyzed the health information management education accreditation system between the Republic of Korea and the United States. Methods: Descriptive analysis and quantitative methodologies were used to compare the education accreditation system and understand the current status of health information management curriculum run by universities in the Republic of Korea and the United States. Results: Regardless of the academic year, the Republic of Korea had one certification system based on subject-based criteria. However, the United States had a certification system for associate, baccalaureate, and master’s degree programs with competency-based criteria. The accreditation system was different in terms of the way the curriculum is certified and the options for the different levels of university degree programs. Conclusion Accordingly, it is necessary to consider improving the quality of health information management personnel at different levels by improving the current accreditation system and differentiating the curriculum according to the degree program levels in the Republic of Korea.

Objectives: The study aims to investigate the influence of oral health service experience on oral health behavior of North Korean defectors and contribute to the development and implementation of oral health education among this population. Methods: A self-reporting questionnaire survey was conducted with 161 North Korean defectors in Hanawon from April, 2015 to September, 2015. Of these participants, 50 were excluded owing to insufficient questionnaire data. The questionnaire was developed based on the WHO’s Oral Health Survey (OHS) and the Korean National Oral Health Survey (KNOHS). Three categories were included in the questionnaire: demographic characteristics, dental service experience in North Korea, and oral health behavior. Results: Males had higher levels of perceived oral health compared to females, with differences according to the region they are from in North Korea. Those who received tooth brushing instruction in North Korea showed a greater tendency to practice tooth brushing after lunch, while those who received oral health examination showed a higher level of use of oral rinses. Further, the experience of dental scaling significantly influenced both practicing tooth brushing after lunch and use of oral rinses. Conclusions This study confirmed that the previous experience of oral health service in North Korea positively influenced current oral health behavior of North Korean defectors. Continued oral health education can enhance their oral health behavior, oral health, and quality of life. Thus, it is suggested that policies and oral health education should be developed according to their characteristics and oral health service experience in North Korea.

There are controversies in timing of the bone graft in the alveolar cleft. In many hospitals, secondary alveolar bone graft is performed and many surgeons or orthodontists maintain that primary or early bone graft have several disadvantages such as maxillary retrusion and poor maxillary development. But Nylen et al. and Rosenstein have reported favorable results. We treated 4 patients of unilateral complete alveolar cleft using early rib bone graft. Presurgical infantile orthodontics were done. At 12 weeks of age the cleft lip was corrected. The repaired lip has molding effect on the greater segment toward the lesser. When good arch alignment had been obtained after the molding period, bone graft was inserted between the segments. We analyzed these 4 patients by using cephalometric analysis, panoramic, occlusal, periapical radiograph and 3D-CT at the age of 12 years 10 months in average and evaluated the survival of the bone graft, facial growth and tooth eruption. In all patients, the grafted rib bones were absorbed partially. The 3 patients without cleft palate have normal maxillomandibular relation but the eruption of teeth was disturbed. The other patient with the cleft palate shows severe maxillary retrusion and disturbed tooth eruption including delayed eruption, underdevelopment and malposition. The additional iliac bone graft were performed in 2 of the patients and is scheduled in the other 2 patients In conclusion early rib bone graft in the alveolar cleft was not successful because of absorption which caused disturbance of teeth eruption.
Absorption ; Cleft Lip ; Cleft Palate ; Fungi ; Humans ; Lip ; Orthodontics ; Retrognathia ; Ribs* ; Tooth ; Tooth Eruption ; Transplants*

Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation ; *Aorta, Thoracic/radiography ; Cardiac Catheterization/*adverse effects/*instrumentation ; Coronary Angiography ; Device Removal/*instrumentation ; Foreign Bodies/etiology/radiography/*therapy ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; *Stents ; Treatment Outcome

OBJECTIVE: Endovascular treatment is one of the most important treatments along with open craniotomy for cerebrovascular surgery. The successful treatment of endovascular disease relies on appropriate instruments and the surgeon's skill. Endovascular treatment needs to provide safe and stable access to the catheter cavity. Additionally, it is important to maintain a round shape without changing to an oval shape. The catheter for endovascular treatment has to be flexible and accommodate at least 0.027 inches of inner diameter. The 6-Fr Navien™ Intracranial Support Catheter (formerly the ReFlex Intracranial Catheter; Covidien Vascular Therapies, Mansfield, MA, USA) provides 0.072 inches of inner diameter. MATERIALS AND METHODS: We reviewed 61 cases for 56 cases of endovascular treatment with a Navien catheter. A triaxial system was used for all procedures with femoral arterial access. The Navien catheter was placed in the petrous segment of the internal carotid artery or third segment of the vertebral artery. The patients had various shapes of intracranial arteries, including tortuous vessels. RESULTS: The Navien catheter was used for 61 cases of endovascular treatment. We had 59 cases of coil embolization at unruptured and ruptured aneurysms and two cases of stent insertion into the middle cerebral artery. All the cases were successful without any catheter-related complications. CONCLUSION: The Navien catheter is a recently developed catheter that has several strengths compared with previously developed catheters. It provides a more stable environment for endovascular treatment. It provides a cavity sufficient for endovascular treatment devices. Additionally, it is sufficiently flexible to approach tortuous vessels.
Aneurysm, Ruptured ; Arteries ; Carotid Artery, Internal ; Catheters* ; Craniotomy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Reflex ; Stents ; Vascular Access Devices ; Vertebral Artery

OBJECTIVE: Researchers and clinicians have been unable to fully elucidate the natural course of and proper treatment for unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm, particularly with regard to whether close observation or surgery is more appropriate. In this retrospective study, we evaluated the safety and efficacy of endovascular coil embolization of small (≤ 5 mm) asymptomatic UIAs by analyzing outcomes and complications associated with the procedure. MATERIALS AND METHODS: We analyzed data from 150 patients with small asymptomatic UIAs (≤ 5 mm) treated with coil embolization between January 2011 and December 2015. Three-dimensional angiography was used to measure aneurysm size. We evaluated procedure-related morbidity and mortality, immediate post-operative angiographic results, brain computed thomography follow-up results on post-operative day one, and clinical progress. RESULTS: UIAs occurred primarily in the anterior circulation area (142 cases, 94.67%), though eight patients exhibited UIAs of the posterior circulation. Following coil embolization, aneurysms with complete occlusion were observed in 137 cases (91.3%). Partial occlusion occurred in five cases (3.33%), while the procedure had failed in eight cases (5.33%). Procedure-related morbidity and mortality were five cases (3.33%) and zero cases, respectively. CONCLUSION: The endovascular treatment of small asymptomatic UIAs is associated with good short-term outcomes without permanent neurologic complications as well as low overall complication and morbidity rates. Thus, the procedure should be considered for patients with smaller asymptomatic UIAs.
Aneurysm ; Angiography ; Brain ; Embolization, Therapeutic* ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Mortality ; Retrospective Studies

OBJECTIVE: The present study analyzed relationship of workplace violence and perpetrators of violence on sleep disturbance among wage workers in Korea. METHODS: The present study used data from the 4th Korean Working Conditions Survey (KWCS) of 2014 in selecting a total of 25,138wage workers as the study population, which excluded those who failed or refused to respond to questions required for the present study. The workplace violence experience group included people who satisfied at least one of six relevant criteria (verbal abuse, unwanted sexual attention, threatening or humiliating behavior, physical violence, bullying/harassment, and sexual harassment) and the group was divided according to whether the perpetrator of violence was a client or colleague. Presence of sleep disturbance was determined based on subjective symptoms felt within the past 12 months by each individual. A multiple logistic regression analysis was performed to identify the effects on sleep distance according to general, occupational, and psychosocial characteristics, as well as the types of workplace violence and perpetrators of violence. RESULTS: Workplace violence was found as a factor affecting sleep disturbance (OR = 3.773, 95 % CI = 3.058–4.655), and with respect to perpetrators of violence, complaint of sleep disturbance symptoms was higher when the perpetrator was a colleague or boss (OR = 5.688, 95 % CI 4.189–7.723) than a client (OR = 2.992, 95 % CI 2.301–3.890). CONCLUSION: Workplace violence had an effect on occurrence of sleep disturbance and when the perpetrators of violence was a boss or colleague at work, the risk for symptoms such as sleep disturbance increased, which indicated the need for appropriate intervention from a workplace healthcare perspective, including preventive education of workplace violence among employees.
Delivery of Health Care ; Education ; Korea ; Logistic Models ; Physical Abuse ; Salaries and Fringe Benefits ; Violence ; Workplace Violence*

PURPOSE: We aimed to discover clinical and angiographic predictors of microvascular dysfunction using the index of microcirculatory resistance (IMR) in patients with ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS: We enrolled 113 patients with STEMI (age, 56+/-11 years; 95 men) who underwent primary percutaneous coronary intervention (PCI). The IMR was measured with a pressure sensor/thermistor-tipped guidewire after primary PCI. The patients were divided into three groups based on IMR values: Low IMR [<18 U (12.9+/-2.6 U), n=38], Mid IMR [18-31 U (23.9+/-4.0 U), n=38], and High IMR [>31 U (48.1+/-17.1 U), n=37]. RESULTS: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups. The door-to-balloon time was <90 minutes in all patients, and it was not significantly different between groups. Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001). In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008). In multivariate regression analysis, age and symptom-onset-to-balloon time were independent determinants of a high IMR (p=0.013 and p=0.003, respectively). CONCLUSION: Our data suggest that age and symptom-onset-to-balloon time might be the major predictors of microvascular dysfunction in STEMI patients with a door-to-balloon time of <90 minutes.
Aged ; Angiography/*methods ; Female ; Humans ; Male ; Microcirculation ; Middle Aged ; Myocardial Infarction/physiopathology/*surgery ; Operative Time ; *Percutaneous Coronary Intervention ; Regression Analysis

Coronary artery aneurysms are detected rarely during coronary angiography, and are associated with injury to the mechanical vessel wall during percutaneous coronary intervention. Potential causes also include atherosclerosis, congenital defects, connective tissue disorders, vasculitis, infection, drug-related injury, and trauma; it can also be idiopathic. The complications of coronary artery aneurysms vary, but they rupture only rarely. However, there is no consensus treatment strategy for coronary artery aneurysm after coronary intervention. We report a case of a 55-year-old male who developed a coronary artery aneurysm and in-stent restenosis after percutaneous coronary intervention with a drug-eluting stent. The aneurysm was treated successfully with the implantation of a graft stent.
Aneurysm* ; Atherosclerosis ; Congenital Abnormalities ; Connective Tissue ; Consensus ; Coronary Angiography ; Coronary Vessels* ; Drug-Eluting Stents* ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Rupture ; Stents ; Transplants ; Vasculitis

A patient came to the hospital with chest pain and was diagnosed with acute myocardial infarction. Coronary angioplasty was performed at the right coronary artery (RCA) and left anterior descending artery (LAD). A bare metal stent (BMS) was inserted in the RCA and a drug eluting stent (DES) was inserted in mid-LAD. The patient was discharged and was followed up as an outpatient without any symptoms. After 6 years, the patient complained of intermittent chest pain. A treadmill test was performed, and the results were positive. Follow-up coronary angiography was performed, and it showed that the DES inserted in mid-LAD had a complete stent fracture at the distal and proximal sites of the stent. Thus, we report a case of complete stent fracture at the proximal and distal sites in one drug eluting stent.
Angioplasty ; Arteries ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Exercise Test ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Outpatients ; Porphyrins ; Stents