• 대한유전성대사질환학회지
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• 제23권2호
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• pp.15-20
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• 2023

Galactosemia is an inborn error disorder of carbohydrate metabolism, caused by metabolic disturbances at various stages of the Leloir pathway. In patients with galactosemia, accurate diagnosis and appropriate care are essential to avoid complications and unnecessary treatments. And a careful differential diagnosis of the type of galactosemia is crucial. Even with an appropriate galactose-restricted diet, long-term complications may occur, especially in patients with classic galactosemia. So new treatment options are being developed. In this review, we will review the new symptoms of each subtype that have been reported recently and GALM (Galactose mutarotase) deficiency, a new form of galactosemia, and treatment policies according to recent guidelines.

• 대한간호
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• 제29권2호
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• 대한약침학회지
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• 제10권3호
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• pp.101-112
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• 2007

Purpose In order to profits to investigator who want to know acupuncture and moxbustion treatments are available to what symptoms today and how goes on the clinical lecture for oriental medical students, this research was carried out. Methods The following conclusion were derived from 745 of patients who treated in acupunture & moxibustion department of Dongeui Oriental Medical hospital from the July in 2006 till January in 2007. Results 1. There were 203(27.25%) persons of Lumbago, 101(13.56%) persons of Bel's palsy, 94(12.62%) persons of Omalgia, 80(10.74%) persons of paralysis of limb, 74(9.94%) persons of disordinary sense of limb and etc. 2. There were 395 females(53.02%) and 350 males(46.98%). 3. The patients over 60th were 26.72%, the 50th were 23.08%, the 40th were 22.14%, the 30th were 15.44%, 20th were 8.45%. So the older the more patients. Conclusion In accordance with the above results, acupuncture & moxibustion teatments are good to use degenerative musculoskeletal disease, pain, paralysis and etc.

• 대한간호학회지
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• 제47권1호
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• pp.110-120
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• 2017

Purpose: The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. Methods: Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. Results: Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. Conclusion: The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation.

• 대한한의학원전학회지
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• 제18권2호통권29호
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• pp.190-204
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• 2005

The purpose of this research is to discover changes of WBC and ANC numbers before and after applying Oriental medicine therapy to blood cancer patients. After that, appropriate music therapy method was well planned and carried for patients. Demonstration and music were conducted according to Ohaeng theory. The oriental music therapy was conducted three hours everyday by listening to music and we made patients participate in playing the instrument for one hour in two times a week. The result was verified in three ways by checking and comparing numbers of WBC, ratio of ANC and New Trophil before and after the experiment. In addition to that verification, we analyzed patients' survey and their response after treatment. The result was that WBC and ANC were efficient as p=0.0419, p=0.0262 each and the ratio of New trophil was not efficient in p=0.999, but partially increased.

• 한국의료질향상학회지
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• 제10권1호
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• pp.20-27
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• 2003

Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.723-726
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• 2005

Osmidrosis axillae is a distressing problem characterized by foul odor at the axillae due to excessive apocrine sweat gland secretion. We introduce a new non-surgical method using a specially insulated needle and high frequency electrocoagulator. From September 2001 to January 2005, 52 patients were treated with this procedure for osmidrosis axillae. In authors' procedure, insulated needle which was designed to protect skin and dermal layer was inserted into the deep dermis of axilla area and apocrine sweat glands were removed by electrocoagulation. Fifty two patients were evaluated more than 6 months after surgery. Among these patients, 48 patients received secondary coagulation procedure. After second operation, all patients were satisfied with postoperation results. We conclude that our method has several advantages such as 1) short operation time, 2) no necessity of postoperative immobilization of shoulder joints, 3) no need of hospitalization, 4) minimal scarring and no bleeding, 5) prevention of skin necrosis, 6) a safer operative method for recurred cases as a secondary method.

• 음성과학
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• 제14권4호
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• pp.221-232
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• 2007

Topiramate (TPM) is a new antiepileptic drug characterized by a clinical effective reduction in seizure frequency and it represents a useful drug effective in a wide range of epileptic patients. Known side effects are represented by weight loss, hypohidrosis, anorexia, sedation, nephrolithiasis, cognitive complaints and language disorders. This study is to examine acoustic characteristics of patients with TPM. 15 patients were assessed through a Computerized Speech Lab (CSL) applied before the beginning of therapy with TPM and 3 months after medication had been stabilized. Tests had been chosen to assess voice onset time (VOT), total duration (TD), vowel formants, loudness, pitch, speaking rate, and articulation patterns. We compared the data from patients and healthy volunteers. The statistical analysis of the results did not show changes in acoustic tests, except for TD which was increased. The increase of the TD is evaluated as a deterioration of fluency. Our results suggest that patients with TPM did not experience acoustic speech changes except that fluency was declined. Unlike previous studies, the medication of TPM has nothing to do with speech problems in patients with epilepsy.

• 항공우주의학회지
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• 제31권1호
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• pp.17-20
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• 2021

As the coronavirus disease 2019 (COVID-19) pandemic continues, doctors face many difficulties in managing patients with respiratory allergies. As research continues, much new knowledge has emerged about the link between COVID-19 infection and respiratory allergies. Studies to date have shown that there is no significant increase in the risk of COVID-19 infection in patients with respiratory allergies. However, in patients undergoing treatment for moderate to severe asthma or allergic rhinitis, more severe clinical manifestations, increased hospitalization period, and increased mortality may occur, so patients need to be managed with more care. In addition to personal efforts, social consideration should be accompanied to prevent deterioration in patients' quality of life with respiratory allergies due to COVID-19. Lastly, as clinical doctors, we should treat patients with respiratory allergies to protect ourselves appropriately by actively utilizing remote medical treatment and minimizing tests that generate droplets. Also, by appropriately educating patients and continuing drug treatment, efforts should be made to ensure that patients receive the best treatment even in a pandemic situation.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.