• Journal of Korea Entertainment Industry Association
• /
• v.15 no.8
• /
• pp.423-432
• /
• 2021

In this study, we investigated and the following conclusions are presented by identifying the current status and problems in order to expand the future's value of the community care project introduced and implemented to improve the quality and care for the elderly's life. First, the needs analysis of the elderly receiving services is composed of patient-centered rather than investigator-centered, and in particular, medical management through medical staff visits should be strengthened, and specialized service items according to gender, age, disability type, and personal preference should be strengthened. This will have to be gradually strengthened. Second, by analyzing the satisfaction, redundancy, and effectiveness of service items, we save money, and consider the consumer-oriented service item composition and application of items necessary for new services. Third, through the introduction of an integrated schedule management system, it is necessary to specialize in pre-booking and visit schedule management between the elderly and the direct service organizations that provide services. Fourth, as an effort to solve the financial problem, it is necessary to prepare a rational resource sharing system with health and medical finance, long-term care insurance system, and social welfare financial project. and it may consider that putting the medical personnel who are from local public medical college input. Through these proposals, the community care business will be able to complete and have future value as a universal aged care system.

• Korean Journal of Clinical Pharmacy
• /
• v.32 no.3
• /
• pp.215-225
• /
• 2022

Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

• The Journal of the Korea Contents Association
• /
• v.22 no.2
• /
• pp.794-802
• /
• 2022

This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

• The Journal of Internal Korean Medicine
• /
• v.43 no.6
• /
• pp.1186-1197
• /
• 2022

Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.

• The Journal of Internal Korean Medicine
• /
• v.43 no.6
• /
• pp.1264-1273
• /
• 2022

Posterior communicating artery aneurysms (PcomAAs) are the second most common type of aneurysm. Large cerebral aneurysms show various neurological symptoms, especially oculomotor nerve palsy (ONP), due to PcomAAs. Recent research has shown that stent-assisted coil embolization has many side effects. We report the effectiveness of Korean medicine in the treatment of ONP due to PcomAAs after stent-assisted coil embolization. A patient with ptosis and limitation of eye movement was treated with Korean medicine, including herbal medicine (Samlyeongbaegchul-san-byeonbang [參苓白朮散變方] and Uwhangchungsim-won [牛黃淸心元]), acupuncture, electroacupuncture, cupping, and moxibustion. Clinical symptoms were observed by images of the inter-palpebral fissure and eyeball movement. After the treatment, the inter-palpebral fissure and eyeball movement were noticeably improved. These findings suggest that treatment with Korean medicine can be an effective option for the treatment of ONP due to PcomAAs after stent-assisted coil embolization.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.10 no.1
• /
• pp.33-39
• /
• 2009

Objects : This study propose to compare on general characteristics of acute stroke patients between Fire-Heat group and Deficiency of Yin group. Method : We recruited acute stroke patient within 4 weeks after stroke admitted to Department of Internal Medicine of Kyunghee University Oriental Medicial Center, Dongguk University Ilsan Oriental Medical Center, Kyungwon University Songpa Oriental Medical Centar and Kyungwon University Incheon Oriental Medical Center from April 2007 to August 2009. We investigate age, sex, type of stroke, past history, general characteristics, smoking, drinking alcohol, marriage sasang constitution, etc. Result : It was significant different in sex, smoking, dringking alcohol and marriage between Fire-Heat group and Deficiency Yin group. We need more cases for another result that could associate with diagnosis of stroke. Conclusion : We found that Fire heat group was more associated with lifestyle than deficiency yin group. Further study will be needed to analysis for the diagnosis and the treatments of stroke.

• Journal of Industrial Convergence
• /
• v.21 no.8
• /
• pp.97-110
• /
• 2023

This study presents a systematic literature review aimed at integrating and analyzing the research findings regarding the components of various self-care intervention programs conducted for individuals with chronic obstructive pulmonary disease (COPD) both domestically and internationally. The paper selection criteria were established based on materials from PubMed, CINAHL, EMBASE, /MEDLINE, RISS, DBpia, KISS, and KMbase databases, covering the period from January 1, 2000, to September 30, 2022. The inclusion criteria included controlled pre-post experimental study designs. A total of 23 studies were included in this systematic review. The intervention-related factors examined included the sample size, type of intervention mediator, intervention frequency, and duration. Additionally, factors associated with intervention effects, such as measurement tools and variables, were analyzed. The findings of the analysis support the notion that self-care intervention programs for COPD can contribute to the prevention of symptom exacerbation and hospital readmissions among patients. Consequently, the development of a tailored self-care intervention program specifically designed for COPD patients in South Korea is warranted, considering aspects such as patient accessibility, convenience, and motivation for long-term sustainability.

• Korean Journal of Psychosomatic Medicine
• /
• v.31 no.2
• /
• pp.50-62
• /
• 2023

Objectives : This study aimed to identify unmet needs and influencing factors for patients who have breast cancer, colorectal cancer, lung cancer, and thyroid cancer. Methods : We reviewed the SCIE publications on unmet need of four prevalent cancer patients published after 2010 through a web search. Results : The measurement tools primarily used were Cancer Survivors' Unmet Needs and Supportive Care Needs Survey questionnaire. Lung cancer patients reported a relatively higher rate of unmet needs. Breast cancer patients frequently reported unmet needs in the healthcare system and information, while thyroid cancer patients in post-treatment management and psychological issues. Colorectal cancer patients reported unmet needs in psychological and comprehensive care domain, and lung cancer patients reported unmet needs in physical and daily life management. Younger age, a shorter time since diagnosis or treatment, and higher levels of anxiety, depression, distress, and reduced quality of life were associated with more significant unmet needs. Conclusions : Unmet needs and influencing factors vary by cancer type. Considering the characteristics of each patient group and unmet needs can help in development of more effective treatment and support programs.

• Journal of Trauma and Injury
• /
• v.36 no.4
• /
• pp.362-368
• /
• 2023

Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5-18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3-23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3-48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.6
• /
• pp.716-725
• /
• 2023

Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.