• Journal of Korean Clinical Nursing Research
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• v.17 no.3
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• pp.455-466
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• 2011

Purpose: The purpose of this study was to investigate the effects of a structured preoperative PCA education on the knowledge and attitude regarding PCA usage, level of pain, and the consumption of analgesics after operation for colorectal surgery patients. Methods: This study was conducted from 18 Feb to 2 May, 2008. Participants were 80 colorectal cancer patients who would use the IV-PCA after colorectal surgery in a cancer hospital in Gyeonggi-do, Korea. Two groups, experimental and control were consisted of 40 patients each. The 20-minute structured education regarding PCA usage was applied to each patient individually in the experimental group but only the routine anesthetic consultation was given to each patient in the control group the day before the surgery. The SPSS/PC 10.0 program was introduced to analyze the collected data on frequency, percentage, mean, standard deviation, $x^2$-test, t-test and paired t-test. Results: The experimental group with the structured preoperative PCA education showed higher knowledge and more positive attitudes regarding the PCA usage than the control group. Also the experimental group showed better pain control and lower consumption of analgesics at 4, 8 and 24 hours after than the control group. Conclusion: The structured preoperative PCA education is an effective nursing intervention for improving the knowledge and attitude of the colorectal surgery patients on the PCA usage, and enabling the patient to take the analgesic more effectively with lower consumption, while reducing the patients' pain after operation.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.13-28
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• 2020

Purposes: The purpose of this study is to analyze the institutional and personal factors that affect the medical utilization of patients transferred to tertiary medical institutions. Methodology: We retrospectively analyzed the 2 weeks electronic medical records of 1,556 patients, who were referred to the tertiary hospital, from June 15 to 26, 2015. The patient's personal characteristics, referral hospital, referral path, medical experiences and expenses were analyzed for 6 months after the patient's first visit. Findings: The largest proportion (848; 54.5%) of referrals was referred from primary clinic but the referrals of the same tertiary hospital level were one in seven (228; 14.7%) of the patients. Most patients (1,401; 90%) were referred from the clinics and hospitals directly and only one in ten (155; 10%) of the patients utilized the medical referral center. Patients who had been referred from tertiary care institutions had significantly higher medical costs than those referred to primary care (7,560,000 vs 2,333,000 won). The institutional factors including the numbers of visits to outpatient clinic, previous history of hospitalization and operation, consultation to other medical departments and hospitalization fee significantly influenced on medical utility pattern. Personal factors including patient's medical diagnosis and department of disease have a highly correlation with patient's referrals. Practical implications: The medical utilization of medical expenses and experiences is influenced by institutional and individual factors, and it is important to establish a referral system considering the institutional factors of the type of referral hospital.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.149-158
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• 2024

Introduction: In this case report, we describe the clinical effectiveness of Yigan-san-gami in improving symptoms in a patient with worsening Alzheimer's dementia after COVID-19 infection. Case presentation: Symptoms of dementia worsened in a patient with Alzheimer's disease after COVID-19 infection. Western medicines were added following neurological consultation. However, there was no medicinal effect. The patient was treated with Korean medicine (Yigan-san-gami) three times a day. We used daily charts, the Korean Mini-Mental State Examination-2 (K-MMSE-2), Clinical Dementia Rating (CDR), and Short Version Geriatric Depression Scale (SGDS) to assess the patient's symptoms. Cognitive decline and behavioral and psychological symptoms of dementia (BPSD) improved following the treatment with Yigan-san-gami. Conclusion: The results suggest that Yigan-san-gami may be effective in improving symptoms of Alzheimer's disease that worsen after COVID-19 infection.

• Korean Journal of Clinical Pharmacy
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• v.11 no.1
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• pp.1-6
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• 2001

This research is conducted to evaluate the clinical and economic benefits from therapeutic drug monitoring(TDM) service on vancomycin in a tertiary general hospital. Total 99 pairs of steady state peak and trough concentrations of vancomycin were obtained from 73 patients. To see the clinical benefits, the appropriateness of vancomycin dosing before TDM was evaluated. In 72 pairs of vancomycin blood concentrations obtained prior to TDM consultation, $47.2\%$ of the cases had reached within therapeutic range. Serum vancomycin levels in patients with $40{\leq}CLcr<60$ (ml/min) were higher and than the levels in patients with 40>CLcr and $60{\leq}CLcr$ (ml/min). Dose reduction rate in patients with creatinine clearance $40{\leq}CLcr<60$ (ml/min) were also significantly higher than those of compared groups ($61.5\%$, p=0.0138). Serum vancomycin concentrations were re-obtained from 21 patients who received modified dose through TDM service. Ninety percent (19/21cases) of them were within the target therapeutic range. For the evaluation of economic benefits from TDM consultation, estimated cost savings were calculated in those patients. The total drug saving were 586 vials in 21 patients. The calculated mean cost saving from the drugs was 314,570 won (range: $11,273\sim473,466)$ per patient. The study revealed that TDM service for vancomycin is necessary because empirical dosing is not effective for obtaining therapeutic drug level, especially patients with mild renal insufficiencies. The cost saving from TDM is also beneficial for the patients.

• YAKHAK HOEJI
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• v.53 no.4
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• pp.217-221
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• 2009

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia and abnormalities in carbohydrate, fat, and protein metabolism which is resulting chronic microvascular, macrovascular, and neuropathic complications. Therefore, correct and consistent educations for pharmacotherapy is important and especially drug consultation by the specialty pharmacist of diabetic pharmacotherapy is necessary for all diabetic patients. The purpose of this study is to evaluate the necessity of the specialty pharmacist of diabetic pharmacotherapy and this study was performed from June 31th, 2008 to October 9th, 2008 in Kangnam St. Mary's Hospital, Seoul, S. Korea throughout the questionnaire and evaluated the total 68 patients who were participating the multidisciplinary diabetes team programs. We evaluated the patient characteristics (n=68), learning status (difficulty 70.4%), wanted further education (68.3%) and preference of educator (pharmacist 46%) after finishing team teaching by multidisciplinary diabetes team program. In conclusion, many diabetic patients(80.3%) wanted individual and further drug consultation by the pharmacists who are specialized in the diabetes individually and they are needed.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.3
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• pp.95-103
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• 2008

Objectives : The purpose of these 2 case studies are to report the effects of fatty liver children treated by oriental medical treatment. Methods : These patient was treated by herbal medicine, acupuncture, moxa, consultation. We observed the improvement of his disease by checking GOT, GPT, GGT, TG, and BMI. Results : By use of oriental medical treatment, we could make a considerable improvement of Child fatty liver. Conclusions These 2 case studies shows that oriental medical treatment can be an effective treatment for Child fatty liver. And the further study is needed with more cases and longer duration.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.3
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• pp.17-24
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• 2008

Objectives : The purpose of this study is to report a case of conversion disorder child treated by oriental medical treatment. Methods : We diagnosed the patient as Soeumin Woolgwang disease and treated him with herbal medicine, acupuncture, moxa, consultation. We observed the improvement of his disease by checking his pseudo-seizure, stool, headache and chest discomfort. Results : By use of oriental medical treatment, we could make a considerable improvement of pseudo-seizure and other symptoms(stool, headache and chest discomfort). Conclusions : This study shows that oriental medical treatment can be an effective treatment for conversion disorder. But the symtoms may recur, so we need continuous observation and management.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.11-18
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• 2010

The clinical assessment of a patient with a cerebral lesion is not easy to physicians. Extensive neuropsycho-logical tests often need both skilled experience and some special tools. Some bedside tests equally provide valuable clues to localize cerebral lesion, when a clinician knows functional anatomy of cerebral hemisphere. In this article, several techniques used to evaluate cerebral cortical function will be introduced.

• Journal of Korean Academy of Dental Administration
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• v.10 no.1
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• pp.1-8
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• 2022

This study introduces research on the quality of medical services, optimization of medical services, dental medical services, implant medical services, and time schedules, as well as the effective process of dental implant medical services, which is expensive and requires a long treatment period. For improvement, it is suggested to evaluate using a time schedule. In this method, a time schedule is prepared in which each step, starting from the patients appointment until the completion of the treatment process, is allotted a certain time. This schedule was finalized in consultation with the employees. When performing all implant operations, the starting time of each item was checked to evaluate the degree of compliance and to understand any reasons for delay in each step. After identifying the causes for delay at each step, suitable steps to rectify the drawbacks were developed, and an optimal plan for patient management was determined. Changes in waiting time and human resource utilization were shown as concrete data, suggesting that such a schedule is meaningful as a decision-making support tool.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.6
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• pp.382-385
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• 2022

Congenital epulis (CE) is an extremely rare benign tumor of the gingiva that is found on the alveolar ridge of newborns, and the main treatment option is simple excision. Postoperative prognosis is very good, and spontaneous regression may occur despite incomplete excision. This report presented a rare case of CE and its healing process after surgery under local anesthesia. The treatment plan was decided upon through consultation between a medical team and the patient's family, with surgical excision for the main lesion, which benefitted from surgery, and follow-up for a very small-sized lesion, which was thought to be appropriate for a newborn. No recurrence was found after its removal, and favorable healing was observed.