• Journal of Acupuncture Research
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• v.18 no.2
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• pp.227-236
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• 2001

Objectives : This study was performed to evaluate the clinical results of the thoracolumbar fracture patients treated with oriental medical methods. Methods : We reviewed 40 patients of thoracolumbar fracture, who were hospitalized at WonKwang University KwangJu Oriental Medical Hospital and treated by oriental medical methods. We classified thoracolumbar fracture according to three column theory and then analyzed the cause of injury, sex-age distribution, treatment, and etc.. Results : 1. The distribution showed female predominance(72.5%) in sex and 70age-bracket predominance in age. 2. In the distribution of causes, the largest group was "lifting heavy objects"(40%) and the next was "slip down"(37.5%). 3. In the duration of symptoms, the largest group was the group of "acutest" (40%). 4. The distribution of injured level was L1 body the most(20%). 5. In classification of fracture, "compression fracture" was the most(57.5%) and the next was "burst fracture", "unstable fracture" in order. 7. Therapeutic effects above "fair" were 37 cases(92.5%). 8. The higher grade of clinical symptoms is, the lower therapeutic effect is. 9. In the distribution of treatment results according to classification of fracture, both the compression fracture and the burst fracture were almost same high and the unstable fracture is relatively lower than them. Conclusions : The result to treating thoracolumbar fracture by oriental medical methods is satisfactory.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Health Policy and Management
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• v.3 no.2
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• pp.130-158
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• 1993

This study was written to discover the changes that may exist in the contents of medical services after introduction of health insurance system, and to identify the net-effect of health insurance system on medical services. Uncomplicated nornmal delivery and appendectomy patients were divided into 4 groups, the non-insured in pre-NHI periods(group A), the insured of health insurance for employees in pre-NHI periods(group B), the insured of regional health insurance for city residents in post-NHI periods(group C) and the insured of health insurance for employees in post-NHI periods(group D). The mehtod of matching was applied to control for major demographic differences among these 4 groups of each disease. In pre-NHI period, the medical services and the variation of medical services of the non-insured were compared with those of the insured. The difference between the change of medical services from group A to those of group C, and the change of medical services from group B to those group D is defined as the net-effect of health insurance. The results are as follows. First, in length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients, frequency of sitz bath in delivery patients, there was net-effect of health insurance in increasing direction. Second, length of stay after delivery or operation, total length of stay, some laboratory examination, amount of several drugs used in appendectomy patients and frequency of sitz bath in delivery patients were significantly more in the insured than in the non-insured group in pre-NHI period. Third, the variation of medical services of post-NHI period was not less then those of pre-NHI period. Fourth, antenatal care on which the third party does not pay and the patient pays for all, was diffrerent by socioeconomic and educational level of patients.

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.28-33
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• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Korean Journal of Adult Nursing
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• v.19 no.3
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• pp.495-507
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• 2007

Purpose: This critical ethnography was performed to explore the experiences of nurses who are working with patients in an industrial disaster hospital. During the research process, I focused on the experiences of conflict in caring patients. Methods: Data for the study came from 13 informants with their corresponding patients through interview and observation from March 2002 to February 2004. The data was examined line by line; then compared and contrasted based on a critical discourse analysis. Results: Nurses' conflicts came from discrepancies of the world views from that of the patients. Such conflicts arose because of various issues as follows: Worker as an individual vs patients, nurse as young women vs the medical profession, hospital as an extended home vs health care setting, and hospitalization as a means to enhance work capacity vs a means of treatment. Conclusion: We need more study on the development of adaptive strategy for the nurses to overcome conflicts during their nursing career. Developing a nurses' and patient role intervention program is needed.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.137-140
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• 2008

Puimonary Langerhans cell histiocytosis is very rare, especially when accompanied by active pulmonary. tuberculosis. A patient was hospitalized due to excessive dyspnea and she was diagnosed with active pulmonary tuberculosis by a sputum AFB smear. The HRCT taken after hospitalization showed multiple micronodules and tiny cysts. An open lung biopsy confirmed the coexistence of pulmonary Langerhans cell histiocytosis.

• Pediatric Infection and Vaccine
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• v.27 no.2
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• pp.134-139
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• 2020

Staphylococcus epidermidis is a part of the normal skin flora of humans. However, it can cause serious infections in people exposed to foreign bodies or in immunocompromised patients. A 13-year-old boy was hospitalized with fever and myalgia. Painful nodular lesions were detected on the scalp, arms, and legs. Pancytopenia and blasts were present in the peripheral blood. He was diagnosed with acute myeloid leukemia. Magnetic resonance imaging of the whole body showed multiple peripheral rim-enhancing, cyst-like lesions. Ultrasonography showed echogenic nodules inside the cystic lesions in the intramuscular space of the arms and legs. Therefore, cysticercosis was strongly suggested initially. However, an abscess was confirmed on sono-guided biopsy and S. epidermidis was isolated from a microbial culture of the tissue. We report a case of multiple disseminated lesions caused by S. epidermidis in a leukemia patient, initially mistaken for cysticercosis.

• Journal of the Society of Disaster Information
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• v.11 no.2
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• pp.183-190
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• 2015

When patients have acute cardiac arrest before they are hospitalized, the ratio of CPR done by the general public is directly related to patient survival ratio. However, compared with that of advanced nations, our nation has low patient survival ratio due to its low ratio of CPR done by the general public. To improve this situation, the current study conducted a pre-survey targeting 3,800 general public to find how to apply an emergent medical system using smart phone location-based service. According to its outcome, first, they have a high level of CPR experience while their recognition of CPR generality is low. Second, their self-confidence in doing CPR significantly differ according to their age, academic achievement and occupation yet with generally low self-confidence. Third, their participation in the emergent medical system using location-based service APPs is high, and has co-relation to their will for CPR, self-confidence in CPR and experience in CPR training.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.800-807
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• 2021

Objectives: This study investigated the efficacy of Korean medical treatment for reflux esophagitis. Methods: We used Korean medical treatment (herbal medicines, acupuncture, herbal acupuncture, and therapy) to treat a hospitalized patient with reflux esophagitis. To evaluate the treatment, we measured the symptoms using the Reflux Symptom Index (RSI) and the Visual Analogue Scale (VAS) for heartburn, acid reflux, chest pain, foreign body sensations in the throat, chronic cough, hoarseness, and bronchial asthma. The generic health status was evaluated using the European Quality of Life Five-Dimension (EQ-5d) Scale. Results: The RSI and EQ-5d scores improved following treatment, but the VAS scores showed that only heartburn, acid reflux, and chest pain symptoms were relieved. Conclusions: This study suggests that Korean medicine may be effective for treating reflux esophagitis.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.86-94
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• 2021

Objectives: The purpose of this study is to report on the efficacy of Korean medical treatment for voiding dysfunction. Methods: We treated a patient with voiding dysfunction using Korean medical treatments (herbal medicines, acupuncture, and herbal acupuncture therapy). To evaluate the results of this treatment, we measured the international prostate symptom score (IPSS) and the visual analog scale (VAS) for residual urination, dysuria, and miction pain. The general health status was evaluated with the European quality of life-5 dimensions (EQ-5d) scale. Results: We observed improvements in the IPSS and the EQ-5d scale after the treatments. Changes in the VAS reflected relief of residual urination and dysuria but not miction pain. Conclusions: This study suggests that Korean medicine may be effective to treat voiding dysfunction.