Background: The efforts to build more “people centered,” “patient centered” health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called “Medical Service Experience Survey (MSES).” There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: “doctor experience,” “nurse experience,” “outpatient service experience,” and “patient satisfaction.” It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as “experiences on medical staffs considering physical exposure” or “experiences related to personal information exposure,” were answered in conjunction with items of “nurse experience.” Besides, patients responded that administrative elements of medical services, such as “experiences of comfort in medical institutions” and “experiences of satisfactory administrative services,” were related to the items of “nurse experience.” The answers of patients who visited traditional medical hospitals and clinics about “doctor experience” and “nurse experience” were not discerned statistically, and the answers to “doctor experience,” “nurse experience,” and “medical institution experience” were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.

Oxidative stress can cause generation of uncontrolled reactive oxygen species (ROS) and lead to cytotoxic damage to cells and tissues. Recently, it has been shown that transient ROS generation can serve as a secondary messenger in receptor-mediated cell signaling. Although excessive levels of ROS are harmful, moderated levels of ROS are essential for normal physiological function. Therefore, regulating cellular ROS levels should be an important concept for development of novel therapeutics for treating diseases. The overexpression and hyperactivation of NADPH oxidase (Nox) can induce high levels of ROS, which are strongly associated with diabetic nephropathy. This review discusses the theoretical basis for development of the Nox inhibitor as a regulator of ROS homeostasis to provide emerging therapeutic opportunities for diabetic nephropathy.

Background: Based on the increase in the needs for convalescent rehabilitation medical services in Korea, this study aims to calculate the needs for rehabilitation services and examine its determinants for 229 regions. Methods: Claim data from the Health Insurance Review and Assessment Service were used to estimate patients who need to receive rehabilitation services, and data from various sources were also used for analysis. The number of cases and incidence rates of hospitalization related to convalescent rehabilitation were calculated to estimate the needs for services by region, and the results were visualized via a map. Multivariate regression and fixed effects regression using panel data were performed to identify the determinants of regional variation of the incidence rate. Results: First, the incidence rate of rural areas such as Jeolla-do, Gyeongsang-do, and Chungcheong-do was higher than urban areas (metropolitan cities). Second, the population, proportion of the elder, medical aid recipients, financial independence, traffic deaths, smoking, diabetes rate, and medical infrastructure correlated significantly with the incidence rate. Third, ‘rho’ values which mean the fraction of variance due to individual terms in panel data regression models were 0.965 and 0.976, respectively. Conclusion The incidence rate of hospitalizations was correlated with most independent variables in this study and there is a gap between urban and rural areas. These regional disparities are fixed in our society. An improved regional convalescent rehabilitation system is suggested to cover the entire area including rural areas with a high rate of aging.

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign, fibro-osseous variant of ossifying fibroma. It exhibits short-term rapid growth and has a high recurrence rate. Herein we describe a case of JPOF of the maxilla that was treated via complete excision utilizing an intraoral approach with immediate reconstruction using an iliac bone graft, in conjunction with a comprehensive review of the literature. A 20-year-old man presented with a mass on his right cheek that he reported had been growing over the last 10 months. In that cheek he had noticed fullness and experienced pressure, tenderness, and fluffiness, with no other ophthalmic or dental symptoms. After clinical, radiological, and histological examinations, the diagnosis was confirmed as JPOF. Surgical excision was performed, followed by immediate reconstruction with an autologous iliac cortical and cancellous bone graft harvested from the right iliac crest under general anesthesia. Good cicatrization of the intraoral surgical wounds and right iliac crest were evident. He was monitored for 6 months after the surgery and exhibited appropriate midfacial contour. There were no signs of recurrence or complications.

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.
Checklist ; Education ; Gyeongsangbuk-do ; Musculoskeletal Diseases ; Occupational Health ; Occupational Medicine ; Volunteers

Cutaneous horn is the clinical entity, which is circumscribed, conical, markedly hyperkeratotic lesion in which the height of the keratotic mass amounts to at least half of its largest diameter. It may be associated with many different pathological lesions. It is a relatively rare and a kind of epidermal tumor that generally appears as a conical projection. Here, we report rare case of congenital cutaneous horn. A 39-month-old female Korean patient presented at our clinic with a mass at the tip of her nose present since birth. Under general anesthesia, cutaneous horn of nasal tip was completely excised without any complications. The operation site was small enough to perform a primary closure, without any nasal deformity. Histopathologically, it was reported as a fibroepithelial polyps. After operation, there is no evidence of recurrence at 16 months of follow-up.

Intraosseous hemangioma is a rare, benign vascular tumor of endothelial origin. It accounts for fewer than 1% of all hemangiomas, and very rarely occurs in the face. Intraosseous hemangioma usually presents as an asymptomatic lesion, but symptoms can occur due to the mass effect. The authors describe a case of intraosseous hemangioma of the zygoma with a review of the relevant literature. A 44-year-old man presented with a chief complaint of painless swelling on the left zygomatic region that had been slowly growing for the past year. On physical examination, a hard, non-movable mass in a deep layer was palpated. On computed tomography performed to evaluate its layers and extent, trabeculation was found inside the mass, but the lack of destruction of the surrounding bone suggested that the mass was benign. Complete surgical excision was performed under local anesthesia. After complete excision of the mass, slight erosions remained on the cortical bone of the zygoma, but because it was small enough not to cause a facial deformity such as depression or asymmetry, no additional reconstructive procedure was performed. There were no symptoms or recurrence during a 8-month follow-up period.

Naso-orbito-ethmoidal (NOE) fractures are complicated fractures of the mid-face. The treatment of NOE fractures is challenging and a comprehensive treatment strategy is required. We introduce a case of NOE fracture treated with open reduction and suspension sutures. A 28-year-old woman presented with a unilateral NOE fracture. To reduce the frontal process of the maxilla, a suspension suture was made by pulling the fragment using a double arm suture via a transcaruncular incision. The suture thread was placed in the horizontal plane. Another suspension suture on the inferior orbital rim assisted reduction procedure, and they passed through the overlying skin. The reduction alignment could be finely adjusted by tightening the transcutaneous suture threads while checking the degree of bone alignment through the subciliary incision. The two suture threads were suspended using a thermoplastic nasal splint. An additional skin incision on the medial canthal area, which would have resulted in a scar, could be avoided. Four months postoperatively, computed tomography showed an accurate and stable reduction. The patient was satisfied with her aesthetic appearance, and functional deficits were not present.

Cutaneous horn is the clinical entity, which is circumscribed, conical, markedly hyperkeratotic lesion in which the height of the keratotic mass amounts to at least half of its largest diameter. It may be associated with many different pathological lesions. It is a relatively rare and a kind of epidermal tumor that generally appears as a conical projection. Here, we report rare case of congenital cutaneous horn. A 39-month-old female Korean patient presented at our clinic with a mass at the tip of her nose present since birth. Under general anesthesia, cutaneous horn of nasal tip was completely excised without any complications. The operation site was small enough to perform a primary closure, without any nasal deformity. Histopathologically, it was reported as a fibroepithelial polyps. After operation, there is no evidence of recurrence at 16 months of follow-up.

Intraosseous hemangioma is a rare, benign vascular tumor of endothelial origin. It accounts for fewer than 1% of all hemangiomas, and very rarely occurs in the face. Intraosseous hemangioma usually presents as an asymptomatic lesion, but symptoms can occur due to the mass effect. The authors describe a case of intraosseous hemangioma of the zygoma with a review of the relevant literature. A 44-year-old man presented with a chief complaint of painless swelling on the left zygomatic region that had been slowly growing for the past year. On physical examination, a hard, non-movable mass in a deep layer was palpated. On computed tomography performed to evaluate its layers and extent, trabeculation was found inside the mass, but the lack of destruction of the surrounding bone suggested that the mass was benign. Complete surgical excision was performed under local anesthesia. After complete excision of the mass, slight erosions remained on the cortical bone of the zygoma, but because it was small enough not to cause a facial deformity such as depression or asymmetry, no additional reconstructive procedure was performed. There were no symptoms or recurrence during a 8-month follow-up period.