• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• Journal of Pharmacopuncture
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• v.25 no.1
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• pp.15-23
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• 2022

Objectives: This study aims to develop a community care model in traditional Korean medicine (TKM) by developing a community care participation model for the health of the elderly and deriving tasks to implement it. Methods: This study implemented a group interview with experts. A fact-finding survey was conducted targeting 16 local governments that are implementing a leading project to identify the status of TKM service provision and welfare service linkage in all regions. An expert group interview (FGI) targeted public and private sector experts for each job role, the former represented by those in charge of the central government's health care policy and administrative delivery system, and the latter by professors majoring in social welfare, professors majoring in health, and local TKM societies. After forming the expert groups, three expert group interviews were conducted. Results: Through collective interviews with experts, a model for providing TKM and welfare services in community integrated care was derived by dividing it into local and central government levels. The strategies and tasks for promoting TKM-oriented health welfare services were derived from 3 strategies, 8 tasks, and 20 detailed tasks. Conclusion: The core direction of the TKM health care model is the region-centered provision of TKM and welfare services. To this end, policy support for the use and linkage of health care service resources is required at the central government level, and linkage and provision of health welfare services centered on TKM are necessary through linkage and convergence between service subjects and between government health care projects.

• Journal of Home Health Care Nursing
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• v.2
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• pp.52-59
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• 1995

This Study was done to examine the home health care service provided by home care nurses and the level of client satisfaction. Data were collected from 60 clients who received services from a home care center. The tool for measurement of satisfaction was composed 13 items and was 3 score scale. The results of this study are summarized as follows ; 1. By the disease pattern, subjects were distributed into cardiovascuvr disease(73.5%), digestire disease(10.2%), endocrine disease (6.1%), Senile dementia(6.1%) and the others(4.0%). 2. By the disease pattern, provided home health care services were follows; In cardiovascular disease and digestire disease, direct nursing service, education and physical assessment were provided every time. In senile dementia, direct nursing services were mainly provided and transfer and medication were rarely provided. 3. The level of satisfaction on provided home health services was high; mean score was 2.4 out of 3.

• Health Policy and Management
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• v.22 no.3
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• pp.451-465
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• 2012

In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.33-44
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• 2019

Objectives: This study aimed to analyze the papers on nursing in the KJHSM (Korean Journal of Health Service Management) (2007-2018), to identify the research trends and to help the future development of nursing research. Methods: The data collection was carried out from September 1, 2019 to September 30, 2019. The 78 copies of the original text were provided by the KSHSM website, DBpia, and NDSL (National Digital Science Library) electronic database. Results: Forty-seven studies had a non-experimental design, with most having a descriptive research design (89.3%). The most common participants were nurses (55.7%) and nursing college students (26.1%). A questionnaire was the most commonly used research tools (96.2%) and data collection methods (95.0%). The major keywords were the terms included in the environmental domain among the meta-paradigms of nursing (43.6%). Conclusions: In order to expand the quantity and quality of nursing science in the KSHSM, efforts are needed to improve the quality of research participants, research tools, and sampling methods.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.18.1-18.9
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• 2016

Background: The aim of this study was to examine the relationship between improvements in lip asymmetry at rest and while smiling after orthognathic surgery in patients with skeletal class III malocclusion. Methods: This study included 21 patients with skeletal class III malocclusion and facial asymmetry. We used preoperative and postoperative CT data and photographs to measure the vertical distance of the lips when smiling. The photographs were calibrated based on these distances and the CT image. We compared preoperative and postoperative results with the t test and correlations between measurements at rest and when smiling by regression analyses. Results: There were significant correlations between the postoperative changes in canting of the mouth corners at rest, canting of the canines, canting of the first molars, the slope of the line connecting the canines, and the slope of the line connecting first molars. The magnitude of the postoperative lip line improvement while smiling was not significantly correlated with changes in the canting and slopes of the canines, molars, and lip lines at rest. Conclusions: It remains difficult to predict lip line changes while smiling compared with at rest after orthognathic surgery in patients with mandibular prognathism, accompanied by facial asymmetry.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.95-99
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• 2017

Schwannoma, also known as a neurilemmomas or neurinomas, is benign peripheral nerve sheath tumors arising from the Schwann cells. About 25~45 % of all schwannomas are found in the head and neck region, and the majority are found in the parapharyngeal space. Schwannoma of the larynx is very rare with an incidence of 0.1~1.5% in all benign laryngeal tumors. Recently, we experienced a case of a pedunculated schwannoma arising from the left aryepiglottic fold in a 80-year-old patient. The tumor was completely excised under direct laryngoscopy with the use of a $CO_2$ laser and subsequently confirmed as schwannoma. So, we report this case with a review of the literatures.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.139-143
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• 2018

Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.115-118
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• 2022

Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.