• Archives of Plastic Surgery
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• v.48 no.3
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• pp.246-253
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• 2021

In order to provide a physiological solution for patients with breast cancer-related lymphedema (BCRL), the surgeon must understand where and how the pathology of lymphedema occurred. Based on each patient's pathology, the treatment plan should be carefully decided and individualized. At the authors' institution, the treatment plan is made individually based on each patient's symptoms and relative factors. Most early-stage patients first undergo decongestive therapy and then, depending on the efficacy of the treatment, a surgical approach is suggested. If the patient is indicated for surgery, all the points of lymphatic flow obstruction are carefully examined. Thus a BCRL patient can be considered for lymphaticovenous anastomosis (LVA), a lymph node flap, scar resection, or a combination thereof. LVA targets ectatic superficial collecting lymphatics, which are located within the deep fat layer, and preoperative mapping using ultrasonography is critical. If there is contracture on the axilla, axillary scar removal is indicated to relieve the vein pressure and allow better drainage. Furthermore, removing the scars and reconstructing the fat layer will allow a better chance for the lymphatics to regenerate. After complete removal of scar tissue, a regional fat flap or a superficial circumflex iliac artery perforator flap with lymph node transfer is performed. By deciding the surgical planning for BCRL based on each patient's pathophysiology, optimal outcomes can be achieved. Depending on each patient's pathophysiology, LVA, scar removal, vascularized lymph node transfer with a sufficient adipocutaneous flap, and simultaneous breast reconstruction should be planned.

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.97-112
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• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• Genomics & Informatics
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• v.18 no.1
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• pp.3.1-3.8
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• 2020

Patient-derived xenograft (PDX) mouse models are frequently used to test the drug efficacy in diverse types of cancer. They are known to recapitulate the patient characteristics faithfully, but a systematic survey with a large number of cases is yet missing in lung cancer. Here we report the comparison of genomic characters between mouse and patient tumor tissues in lung cancer based on exome sequencing data. We established PDX mouse models for 132 lung cancer patients and performed whole exome sequencing for trio samples of tumor-normal-xenograft tissues. Then we computed the somatic mutations and copy number variations, which were used to compare the PDX and patient tumor tissues. Genomic and histological conclusions for validity of PDX models agreed in most cases, but we observed eight (~7%) discordant cases. We further examined the changes in mutations and copy number alterations in PDX model production and passage processes, which highlighted the clonal evolution in PDX mouse models. Our study shows that the genomic characterization plays complementary roles to the histological examination in cancer studies utilizing PDX mouse models.

• Journal of Sasang Constitution and Immune Medicine
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• v.32 no.3
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• pp.46-54
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• 2020

Introduction This study aims to report a significant improvement of Sjögren's syndrome patient with irritable bladder, diagnosed as 'Soyangin chest-binding symptomatology' based on Sasang medicine. Methods The patient had treatment with 'Dojeokganggi-tang' and western medications. We evaluated the treatment outcome of Sjögren's syndrome symptoms by using a numerical score of 0 to 10, based on the patient's subjective discomfort of dry eye and dry mouth, and irritable bladder symptoms by recording the number of night urination every month. Results Sjögren's syndrome symptoms were significantly improved, and the number of night urination was decreased. After 41 weeks of treatment, the patient didn't have dry mouth any more and had only a little dry eye. The number of night urination was decreased from 3-4 times to once a night. Discussion The patient diagnosed with Sjögren's syndrome, treated with Dojeokganggi-tang and western medications for 41 weeks, showed a significant improvement in dry eye, dry mouth, and night urination compared to the first visit.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• Journal of Korean Traditional Oncology
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• v.17 no.2
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• pp.17-22
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• 2012

Background : Sulfasalazine for treating ulcerative colitis has a clinical limitation due to its adverse effects. This case is about a patient with ulcerative colitis who could not tolerate sulfasalazine and was improved by Do-che decoction-based Korean medicine. Method and Results : Purulent and bloody diarrhea more than 20 times a day, mild fever, chilling and tenesmus were main symptoms of this patient who was diagnosed as ulcerative colitis 10 years ago. Do-che decoction-based Korean medicine which was recommended for purulent and bloody diarrhea in Dong-Ui-Bo-Gam, the classic literature of Traditional Korean Medicine was given to the patient for more than 1 month. After treatment, the frequency of purulent and bloody diarrhea, tenesmus and fever was decreased remarkably, and C-reactive protein, erythrocyte sedimentation rate, white blood cell count and maximum temperature also dropped to the normal range. Conclusion : Do-che decoction-based Korean medicine has a potential effect and may be a alternative therapeutic option in patients with ulcerative colitis who cannot tolerate sulfasalazine due to its adverse effects.

• Industrial Engineering and Management Systems
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• v.8 no.1
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• pp.37-46
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• 2009

Patient safety has become a growing concern in health care. The U.S. Institute of Medicine (IOM) report "To Err Is Human: Building a Safer Health System" in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. However, many adverse events and errors occur in surgical practice. Within all kinds of surgical adverse events, wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events are the most devastating, unacceptable, and often result in litigation. Much literature claims that systems must be put in place to render it essentially impossible or at least extremely difficult for human error to cause harm to patients. Hence, this research aims to develop a prototype system based on active RFID that detects and prevents errors in the OR. To fully comprehend the operating room (OR) process, multiple rounds of on site discussions were conducted. IDEF0 models were subsequently constructed for identifying the opportunity of improvement and performing before-after analysis. Based on the analysis, the architecture of the proposed RFID-based OR system was developed. An on-site survey conducted subsequently for better understanding the hardware requirement will then be illustrated. Finally, an RFID-enhanced system based on both the proposed architecture and test results was developed for gaining better control and improving the safety level of the surgical operations.

• 한국정보통신설비학회:학술대회논문집
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• 2007.08a
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• pp.381-385
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• 2007

As development of wireless communication technology has promoted mobility, Location Based Service (LBS) became embossed. The LBS is a service to recognize and utilize a location of a person or a thing through a device that ensures mobility based on wireless communication network. This paper thus researches on Healthcare Method to respond to emergency rapidly by recognizing a patient's location with the LBS. The LBS also provides location information of a user as well as remote management of organism data such as ECG data or pulse, which is transferred to a hospital or an emergency room.

• 대한상한금궤의학회지
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• v.7 no.1
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• pp.65-73
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• 2015

Objective : The purpose of this paper is to report the effect of Sosiho-tang gagambang on Obesity based on Shanghanlun provisions Methods : According to a disease pattern identification diagnostic system based on Shanghanlun provisions, the patient was diagnosed as Yangmyung-byung, and treated for 90 days with Soshiho-tang gagambang that Scutellariae Radix was substituted with Salviae Miltiorrhizae Radix. The result of treatment was evaluated by Body Mass Index(BMI). Results : After taking Soshiho-tang gagambang for 90 days, the patient's BMI was decreased, and the patient is cured of Obesity. Conclusions : This study suggests that the treatment based on Shanghanlun provision has efficacy on Obesity. In addition, further studies are necessary in order to discover the roles of flavor of Shanghanlun herbal decoctions, and ensure the safety of it.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.05
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• pp.155-159
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• 1995

A design method that can easily construct intelligent patient monitoring systems is proposed. To achieve the design method, the SES/MB concept and a discrete event-based logic control formalism based on a set theory is introduced. In this control paradigm the controller expects to receive confirming sensor responses to its control commands within definite time windows determined by DEVS model of the system under control. Because data to be used for rule-based symbolic reasoning are to be abstracted, several AI methods are applied the processes. These methods are applied to intelligent patient monitoring systems so that they facilitate transformation from low level raw data to high level linguistic data. Model-based system representations have advantages of reusability, extensibility, flexsibility, independent testability and encapsulation.