• 한국의료질향상학회지
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• 제4권2호
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• pp.184-195
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• 1997

Background : The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital. Methods : The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol. Result : The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'. Conclusion : In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.

• Clinics in Shoulder and Elbow
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• 제22권2호
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• pp.61-69
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• 2019

Background: The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP. Methods: Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure. Results: There was a statistically significant difference in ${\Delta}ASES_{3months}$ ($ASES_{3months}-ASES_{first}$) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05). Conclusions: This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

• Advances in pediatric surgery
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• 제13권2호
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• pp.212-216
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• 2007

Migration of a peritoneal catheter of a ventriculoperitoneal shunt into the scrotum is a rare complication. We treated a case of catheter migration in the scrotum. A 12-year old boy, who had had a ventriculoperitoneal shunt at the age of 4 months due to neonatal hydrocephalus, visited the outpatient clinic because of a right inguinal hernia. On physical examination, a firm mass was found in the left scrotum. Pelvic X-ray demonstrated a coiled catheter in the left scrotum. The catheter was successfully removed by exploring the left patent processus vaginalis after high ligation of the hernia sac. This case suggests a suction action of the patent processus vaginalis and the possibility of catheter migration long after shunt catheter insertion.

• Journal of Chest Surgery
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• 제51권3호
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• pp.205-208
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• 2018

A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

• Journal of Chest Surgery
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• 제55권2호
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• pp.183-187
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• 2022

Flail chest is a critical medical condition in which multiple segmentally fractured adjacent ribs cause paradoxical movement of the thoracic cage in patients with severe blunt trauma injury. Surgical stabilization is considered essential in patients who require mechanical ventilation. However, there is no consensus on which surgical procedure to choose among the various available techniques or when to perform surgery. We report the case of a patient with traumatic anterior flail chest due to bilateral multiple fractures of the ribs requiring surgical stabilization in whom weaning from mechanical ventilation had failed. The Nuss procedure using double bars with the bridge technique was performed for chest wall stabilization. The patient was weaned from mechanical ventilation on postoperative day 44 and she underwent bar removal on postoperative day 71. After extensive rehabilitation for multiple trauma, she was discharged successfully. The patient currently shows no recurrence of chest wall depression in outpatient follow-up.

• 한방안이비인후피부과학회지
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• 제16권1호
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• pp.130-140
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• 2003

Objectives : Lately the oriental medical treatment of Bell's palsy is various. In various treatments. this study reports the effect of our clinical treatment using aqua-acupuncture with hominis placenta and electroacupuncture treatment for Bell's palsy, The other purpose of this study is to compare the outcome of inpatient group with that of outpatient group. Materials and Methods : From March 1, 2003 to June 30, 2003, we observe 25 patients who visited to the department of oriental medical surgery, ophthalmology & otolaryngology, in oriental medicine hospital Sang-ji university with Bell's palsy. limited to patients who receive treatment more than 5th times and 4 weeks poured aqua-acupunture with homonis placenta both inpatient group and outpatient group, Inpatient group used electroacupunture treatment after 1 week after onset and outpatient group used electroacupunture treatment after 4 weeks after onset. Results and Conclusions : 40$\%$ were male and 60$\%$ female. Of 25 cases. 30's and 50's were 24$\%$ respectively, 40's, 60's and over 70 were 16$\%$ respectively, 20's were 4$\%$. 50$\%$ of male and 60$\%$ of female had the affected side at left side and right occured at 50$\%$ of male and 40$\%$ of female. The most common cause of Bell's palsy was nonspecific 36$\%$, followed by labor 28$\%$, stress 20$\%$, In 48$\%$ of all cases, 2~3 days were spent before a patient visited the hospital after onset, followed by 4~7 days (24$\%$), 44$\%$ were treated 11~20 times followed by those who received 21~30 times (28$\%$). The results of treatment with aqua-acupunture wth hominis placenta and electroacupunture treatment showed that 21 of 25(84$\%$) patients achived fair or more recovery. the overall therapeutic rate of inpatient group was 90.9$\%$, which was higher than that of outpatient group(78.6$\%$).

• 한국간담췌외과학회지
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• 제28권1호
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• pp.109-113
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• 2024

Cholangiocarcinoma is a heterogeneous group of aggressive tumors that correspond to the second most common primary liver tumor. They can be classified according to their anatomical position concerning the biliary tree, and each subtype demonstrates different behavior and treatment. A 38-year-old male patient presenting solely right lumbar pain was diagnosed with a 7 cm hepatic tumor involving segments I, Iva, and VIII associated with involvement of the hepatic veins. He underwent a bloc resection of hepatic segments I, II, III, IV, partial V, partial VII, and VIII; right, middle, and left hepatic veins; and inferior vena cava segment, with perfusion of the remaining liver in situ with a preservation solution. As the patient had a large accessory inferior right hepatic vein draining the remaining liver, no reimplantation of hepatic veins was necessary. He remained clinically stable in outpatient follow-up, with excellent performance status-current survival of 2 years 6 months after surgical treatment.

• Archives of Reconstructive Microsurgery
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• 제20권2호
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• pp.108-112
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• 2011

Purpose: Gracilis muscle free flap transplantation is chosen in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity. We set a study to search for gracilis free flaps to know whether symptoms were cured or recurred in patients that have passed over 10 years from flap transplantation. Materials and Methods: From August 1995 through September 2010, we have performed 28 cases of gracilis muscle free flap in the lower extremities. Ever since no case visited to demand any discomfort, breakdown or recurrence in the flap site on outpatient basis. We made a telephone call to patients or relatives documented in the medical record and only 2 cases visited outpatient department and 9 cases postponed the visit who satisfied with the final result but 17 cases had wrong telephone numbers. Causes, area of lower extremity, recipient vessels in the lower extremity, condition of the donor thigh and overall satisfaction of the flap transplantation in activities of daily living were investigated and written down in the medical record. Results: 11 cases were reviewed after average postoperative 13.7 years. Gracilis muscle flaps were not break down at the recipient site in all cases. The wound of donor thigh wound healed good and overall activities of daily living was satisfied in all cases. Conclusion: Gracilis muscle flaps which had performed and followed up average 13.7 years revealed confident in the medium sized soft tissue defect and bone exposure from trauma and chronic osteomyelitis in the lower extremity.

• 융합정보논문지
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• 제12권2호
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• pp.184-191
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• 2022

본 연구는 자동차보험 이용환자들의 효율적 관리방안을 모색하는데 필요한 기초정보를 제공하고자 보건의료빅데이터개방시스템에 등록된 2016년부터 2020년까지 5개년 자동차보험 진료비 심사자료를 대상으로 분석하였다. 분석결과, 자동차보험 입원진료비 내역 구성비율 1순위는 상급종합병원은 처치 및 수술료, 종합병원·병원·의원은 입원료, 한방의료기관(한방병원, 한의원)은 처치 및 수술료, 치과병원은 처치 및 수술료 이었다. 외래진료비 내역 구성비율 1순위는 양방의료기관(상급종합병원, 종합병원, 병원, 의원)은 진찰료, 한방의료기관(한방병원, 한의원)과 치과의료기관(치과병원, 치과의원)은 처치 및 수술료 이었다. 자동차보험 입원 건당 진료비에는 투약료, 마취료, 특수장비 비율이 영향요인이었으며, 외래 건당 진료비에는 이학요법료 비율이 영향요인으로 확인되었다.

• 대한족부족관절학회지
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• 제17권3호
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• pp.225-233
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• 2013

Purpose: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. Materials and Methods: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. Results: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. Conclusion: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.