Analysis of the Effects of a Health Policy Capacity Development Education Program as a Public-Private Partnership Model in Official Development Assistance for Health Policy Administrators / 한국직업건강간호학회지

Purpose@#This study analyzed the effects of a health policy capacity development education program as a publicprivate partnership (PPP) model in official development assistance (ODA) for health policy administrators. @*Methods@#Between October 2015 and September 2017, 41 participants from underdeveloped countries completed the three-week education program at K university, following the official selection process of the Korea International Cooperation Agency (KOICA) and each country’s embassy. @*Results@#The effects of the health policy capacity development education program differed significantly according to participants' age (p=.043), country region (p=.045), and academic or professional degree (p=.007). Academic or professional degree significantly predicted the effects of the program (β=.41, p=.007), explaining 21.7% of the variance in the regression model. @*Conclusion@#The current selection process for ODA program participants considers recommendations from each country’s embassy to determine eligible candidates. The hosting institution’s opinions or suggestions regarding participants’ professional expertise or work experience, country region, or demographic characteristics should also be considered in the participant selection process.

Knowledge and Behavior of Visitors in the Prevention of Respiratory Tract Infections in an Emergency Service, Hospital / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the effects of emergency setting visitors' knowledge and behavior patterns in relation to prevention of respiratory tract infections. METHODS: A descriptive survey was used. The participants were visitors to the emergency service in ‘D’ general hospital in ‘D’ city, and the data were collected from July 1 to September 1, 2016. The collected data were analyzed using frequency analysis, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Factors influencing prevention of respiratory tract infections were visitors' education level, methods of dissemination of prevention information, and participants' knowledge with regard to preventive methods. The explanatory power was found to be 35% in the regression model. CONCLUSION: The findings indicate that visitors' education level, knowledge of infection prevention, and the dissemination of information regarding infection prevention by the hospital play an important role in the prevention of respiratory tract infections in emergency services in the hospital. These results highlight the need for a customized education program for prevention of respiratory tract infections in emergency settings. Programs should take into consideration the educational background of visitors, and provide them with appropriate information regarding infection prevention.

Timing of Surgical Management of Papillary Thyroid Cancer Diagnosed during Pregnancy

BACKGROUND AND OBJECTIVES: Although the thyroid cancer occurs in every one of 1000 pregnant women, the optimal timing of surgery is still uncertain. The aim of this study is to propose the timing of surgical management of papillary thyroid cancer in pregnant woman. MATERIALS AND METHODS: The authors reviewed the medical records of papillary thyroid cancer patients diagnosed during pregnancy in our hospital from May 1st, 2013 to April 30th, 2015. We analyzed the changes of radiologic and pathologic findings during prenatal and postpartum period. RESULTS: 17 of 4978 patients were diagnosed with papillary thyroid cancer. 10 of 17 patients enrolled in this study. Each size of thyroid cancer in 1st trimester, in 2nd trimester, in 3rd trimester, and after delivery was 11.30±6.01 mm, 12.74±7.79 mm, 13.82±9.93 mm, and 13.82±8.19 mm, respectively. No patient showed the recurrence or death after surgery. CONCLUSION: There was no statistical significance on the prognosis of papillary thyroid cancer during prenatal and postpartum period. The authors propose that the surgical treatment of papillary thyroid cancer diagnosed during pregnancy could be delayed after delivery.

Timing of Surgical Management of Papillary Thyroid Cancer Diagnosed during Pregnancy

BACKGROUND AND OBJECTIVES: Although the thyroid cancer occurs in every one of 1000 pregnant women, the optimal timing of surgery is still uncertain. The aim of this study is to propose the timing of surgical management of papillary thyroid cancer in pregnant woman. MATERIALS AND METHODS: The authors reviewed the medical records of papillary thyroid cancer patients diagnosed during pregnancy in our hospital from May 1st, 2013 to April 30th, 2015. We analyzed the changes of radiologic and pathologic findings during prenatal and postpartum period. RESULTS: 17 of 4978 patients were diagnosed with papillary thyroid cancer. 10 of 17 patients enrolled in this study. Each size of thyroid cancer in 1st trimester, in 2nd trimester, in 3rd trimester, and after delivery was 11.30±6.01 mm, 12.74±7.79 mm, 13.82±9.93 mm, and 13.82±8.19 mm, respectively. No patient showed the recurrence or death after surgery. CONCLUSION: There was no statistical significance on the prognosis of papillary thyroid cancer during prenatal and postpartum period. The authors propose that the surgical treatment of papillary thyroid cancer diagnosed during pregnancy could be delayed after delivery.

Histopathologic Factors affection the Results of Fine Needle Aspiration Cytology in the Diagnosis of Breast Cancer / 한국유방암학회지

The diagnostic accuracy of fine needle aspiration cytology (FNAC) had been reported about 88-99% in the preoperative diagnosis of breast cancer. High false negative results were reported in the diagnosis of breast cancers, which were small size desmoplastic type, infiltrating lobular cancer, tubular cancer and mucinous cancer. The purpose of this study is to define the possible histopathologic characteristics of breast cancer affecting the results of fine needle aspiration cytology. From Jan. 1997 to Dec. 1998, we performed 622 cases of FNAC at the department of surgery, Korea University Hospital. Among these aspirate, 246 cases were followed by subsequent pathological confirmation and were included in this study. The results of fine needle aspiration cytololgy were classified as benign, suspicious and malignant cells. Pathological reports for breast specimens were reviewed for the size, the location, grade or pathological subtypes and presence or fibrosis in the breast lesions. The pathological characteristics were compared statistically with the results of fine needle aspiration cytology. The likelihood ratios for malignant, suspicious, atypical, benign and unsatisfactory cytological diagnosis were 98.7, 5.5, 1.1 and 0.6, respectively. Absolute and complete sensitivities for the malignant lesions were 64.5% and 90.3%. The specificity was 71.9%. False negative and positive rates were 4.3% and 0.7%. The predictive value for malignant cytology in malignancy was 98.4%. The rate of unsatisfactory diagnosis was 9.3%. The range of tumor size is from 0.6 cm to 6.5 cm. The concordance rates of FNAC results wee 75% of less than 1 cm, 60.7% of 1-2 cm, 76.5% of 2-5 cm, and 50% of greater than 5cm of tumor, respectively (p=0.01). The location of tumor also affect the FNAC result and the highest concordant rate was found in the tumor of lower outer quadrant of breast (73.3%, p=0.001). The Bloom-Richardson grade histologic type of breast cancer also affect the FNAC result. Low grade tumor, medullary carcinoma, metaplastic, carcinoma, lobular carcinoma, adenoid cystic carcinoma and mucinous carcinoma usually showed discordant FNAC results. The presence or absence of fibrotic pathology did not affect the FNAC result (p=0.39) In conclusion, the sensitivity of FNAC was 90.3% in the diagnosis of breast cancer and the false negative rate was 4.3%. The great concordance of FNAC diagnosis was found in the patients with tumor of less than 5cm and located in the axilla and locoregional recurrent area. The FNAC results of breast cancer were frequently incorrect in the low grade tumor and cancer of rare pathological type such as lobular, medullary, mucinous and adenoid cystic carcinoma of breast.

Symptomatic Primary Hyperparathyroidism

BACKGROUND: Primary hyperparathyroidism is a relatively frequent disease in western countries. The rate of occurrence in Korea is increasing due to increased concern of people and the development of imaging techniques. METHODS: The purpose of this study is to evaluate the clinical characteristics of patients with primary hyperparathyroidism by a retrospective analysis of their medical records. RESULTS: 19 patients with symptomatic hyperparathyroidism underwent a parathyroidectomy from Dec. 1987 to Aug. 1997 at the Department of Surgery, Korea University Hospital. The mean age of the patients was 44.6 years old, and the male-to-female ratio is 7:12. The major symptoms were generalized weakness (47.4%), polydipsia (36.8%), neck mass (36.8%), and arthralgia (15.8%) in order of frequency. Associated conditions during admission were urinary tract stones (21.1%), thyroid nodules (15.8%), degenerative osteoarthritis (10.5%), and pathologic fracture (10.5%). The mean duration of the major symptom of hyperparathyroidism was 20.6 months. The level of preoperative serum calcium was 13.2+/-2.1 mg, and that of the ionized calcium was 5.8+/-0.7 mg/dl. The level of serum parathormone was greatly higher than the standard value of hospital laboratory (687.2 pg/ml, reference value: 9~55 pg/ml). The true positive rates of imaging study were 78.9% of the hand and skull plain films, 71.4% of the neck CT scans, 40.0% of the neck sonograms, 80.0% of the Tl-c subtraction scans and 100% of the Sestamibi scans. One enlarged parathyroid gland was removed in each of 18 cases and two glands were removed in 1 case. The pathologic types of the enlarged glands were adenomas (16 cases), carcinomas (2 cases), and hyperplasia (1 case). The mean size of the parathyroid tumors was 2.2 cm X 1.7 cm X 1.2 cm, and the mean weight was 7.7 gram. Postoperative hypocalcemia developed in 15 patients and was the most severe on postoperative 3rd day. CONCLUSION: There was 20.6 months interval from the onset of patients' symtoms to the time of parathyroidectomy. Endocrine surgeons should pursue detecting the operable parathyroid tumors and remind medical endocrinologists that the best way of localizing parathyroid tumors is through an operation.