• Journal of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.3
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• pp.113-128
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• 2012

Objectives : This study was performed to investigate the effect of Needle-Embedding Therapy in early stage of intractable peripheral facial paralysis. Methods : 46 patients with severe peripheral facial paralysis were treated with oriental medicine therapy including Needle-Embedding Therapy in their early stage. We evaluated the effect of Needle-Embedding Therapy by House-Brackmann Grading system, decrease of subjective symptoms and satisfaction measurement. Results : After treatment, HB-Scale grade was significantly decreased(p-value<0.001). More than 50% of subjective symptoms were disappeared in 82.61% of patients. 80.48% of the patients was satisfied with the Needle-Embedding Therapy. Conclusion : Needle-Embedding Therapy could be effective to improve symptoms of severe peripheral facial paralysis in early stage. Further studies will be required to identify the beneficial effect of Needle-Embedding Therapy in early stage of peripheral facial paralysis.

• The Journal of Korean Medical History
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• v.32 no.1
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• pp.1-10
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• 2019

The Taesangugeupbang (Emergency Prescriptions for Childbirth) is a medical text written by Li-Chengong of China in the early 14th century. It incorporates forms of obstetrics and gynecology in use in the Chosun Dynasty and is quoted in the Hyangyakjibsungbang (Compendium of Prescription from the Countryside), the Euibangyoochui (Classified Collection of Medical Prescriptions), and the Taesanjibyo (Collection of Essentials for Childbirth). The recent rediscovery of Taesangugeupbang manuscripts in Japan has enabled full-scale research of this text. This article is based on a study of these manuscripts and attempts to synthesize the text through the various documents. The article suggests that: (1) critical texts for understanding the Taesangugeupbang include the Uijeoggo (A Review of Medical Books), the Euibangyoochui, and the Taesanjibyo; (2) there is a possibility that the Taesangugeupbang had disappeared from use in Joseon by the late 15th century; (3) the Taesangugeupbang complemented the treatment regimen of other texts and influenced the development of early Chosun ophthalmology; (4) The Taesangugeupbang is quoted in many Joseon's medical texts and is related to the author's mentor.

• Journal of Korean Biological Nursing Science
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• v.16 no.4
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• pp.259-266
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• 2014

Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

• Journal of The Korean Radiological Technologist Association
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• v.27 no.2
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• pp.137-147
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• 2001

For the cancer of the liver, surgery has been the best treatment, while patients who have the cancer of the liver in its early stages or metastatic liver cancer hardly be healed by surgery tend to be treated with PEIT (Percutaneous Ethanol Injection Thera

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.4
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• pp.57-69
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• 2012

Objective : The purpose of this study is research on three cases of recurrence facial palsy with sequelae. Method : The authors observed patients by the House-Brackmann grade system and by the Scale of Peitersen for operated acupuncture treatment, herbal treatment and herbal acupuncture. Result : After the treatment, the House-Brackmann grades were decreased in two cases of three and the Scale of Peitersen grades were decreased in two cases of three. Conclusion : These result suggest that early admission with Korean medicine treatment could be more effective in recovery of recurrent peripheral facial nerve palsy with sequelae.

• The Journal of Korean Medical History
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• v.21 no.2
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• pp.79-93
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• 2008

Through researching 鄕藥救急方, the oldest medical text published in Korea in existence known to date, a study from a Traditional Korean Medicine perspective was conducted. This study aims to observe the treatment of oral, glottal, labial, and dental diseases starting from 統一新羅時代 to the Koryo dynasty from a historical perspective and also find out what clinical significance it withholds. "鄕藥救急方" proposes methods of nurturing the teeth and in doing so displays the tendency of Traditional Korean Medicine of putting much weight on preventing diseases and nurturing the body. "鄕藥救急方" considers the oral, glottal, labial, and dental diseases as not only fundamental problems in itself but also treats them from a perspective that they are results of disharmony among the five viscera and the six bowels. The treatment methods mentioned in "鄕藥救急方" are directly cited in "鄕藥集成方" of early Chosun dynasty. In "東醫寶鑑" of mid-Chosun dynasty, however, changes and modificatios are made to the prescriptions.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.4
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.85-87
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• 1989

Herpes simplex encephalitis (HSE) is one of the fulminant necrotizing, often fatal sporadic form of the encephalitis caused by herpes simplex type I virus. Characteristically, there is early and almost constant involvement of one or both temporal lobes, although there are common additional areas of involvement. Appropriate early treatment following correct diagnosis by clinical findings, CSF study, EEG and several radiological studies including angiography, redionuclide studies, CT or MRI can reduce its mortality and severity of the sequelae. We report a case of HSE diagnosed by adjuvant study of $^{99m}Tc-HMPAO$ regional cerebral blood flow SPECT, which showed a marked increase in bitemporal cerebral blood flow in a 24-year-old man.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.254-259
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• 2009

Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.