• The Journal of the Korean dental association
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• v.48 no.7
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• pp.538-546
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• 2010

Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.

• Journal of Internet Computing and Services
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• v.19 no.5
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• pp.97-105
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• 2018

In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.

• The Korean Journal of Cytopathology
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• v.19 no.2
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• pp.99-106
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• 2008

Background : Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care. Methods : We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up). Results : The thyroid was the most common organ system (933 cases, 80.9%), Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases. Conclusion : For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.251-255
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• 2015

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.86-89
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• 2014

Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• Journal of Korean Critical Care Nursing
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• v.15 no.1
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• pp.13-23
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• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• Health Policy and Management
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• v.33 no.2
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• The Journal of the Convergence on Culture Technology
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• v.4 no.2
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• pp.75-80
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• 2018

Since the introduction of the Foreign Patient Assistance Law in 2009, more than 300,000 foreign patients are visiting Korea each year due to the efforts of overseas patient attraction organizations, host companies and governments. Despite these achievements, however, the company is confronted with limitations in product development and the rate of patient population growth is slowing. Therefore, this study suggests the importance and meaning of various product development through the hierarchical analysis (AHP) on the major factors of product development of medical tourism services, and suggests direction of product development in domestic medical tourism industry in the future.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.381-388
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• 2010

Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.