• Title/Summary/Keyword: medical approach

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A System Approach to the Framework of Medical Tourism Industry (의료관광산업의 구조에 대한 시스템 접근법)

  • Ko, Tae-Gyou;An, Moo-Eob
    • Korea Journal of Hospital Management
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    • v.25 no.1
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    • pp.32-45
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    • 2020
  • Purpose: The purpose of this research is to develop two medical tourism system models which explain medical tourism phenomenon with a systemic approach. Methodology/Approach: This research was conducted using a qualitative data analysis which mainly refer previous references in relation to medical tourism in the areas of tourism and medicine. Leiper's tourism system model was utilized as a conceptual framework. In-depth interviews with experts in the area were attempted in order to pretest the models. Findings: This research suggests a medical tourism system framework and a medical service provision framework. The first model presents medical tourism components and their relationships within a framework presented in a diagram. The second model shows the relationships among medical services required by medical tourists, the service providers, and service human resources along with movements of medical tourists. Practical Implications: The first model presents a spatial composition of medical tourism components and their relationships, whereas the second model shows the linkage among medical services, the service providers, and relevant service human resources along with time sequential steps of medical tourists. These two models are complementary and may be used as useful tools to observe medical tourism phenomenon with a systemic and holistic approach. These two models may enable stake holders avoid unnecessary confusions and conflicts that result in duplication of government policies and a waste of budget and human resources.

MIDFACIAL DEGLOVING APPROACH IN MIDFACIAL BONE FRACTURE : THE REPORT OF CASES (Midfacial degloving approach를 이용한 중안면 골절 환자의 치험례)

  • Kim, Hyeon-Min;Jeong, Jong-Cheol;Song, Min-Seok;Jang, Jung-Hui;Kim, Nam-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.74-81
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    • 2005
  • In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

Searching for a Social Solution for the Humidifier Disinfectant Disaster in Korea (가습기살균제 참사에 대한 사회적 해법의 모색)

  • Lee, Young Hee
    • Journal of Environmental Health Sciences
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    • v.45 no.4
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    • pp.295-309
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    • 2019
  • Eight years have passed since the Korean government's medical agency officially reported that the fatal lung disease found in some hospitals in 2011 was caused by chemical disinfectants used in household humidifiers, marking the introduction of the humidifier disinfectant disaster. Over the past eight years, a medical-scientific approach has been taken by the Korean government in its efforts to solve the problems in terms of relief of and compensation for the potential victims. One of the unintended consequence of this approach has been the fact that the number of "official victims" recognized by the government is quite small compared to the total number of applicants who claim to be suffering from the humidifier disinfectant disaster. This is mainly due to the fact that the medical-scientific approach relies on excessively strict, rigid, and narrow medical-scientific criteria provided by medical experts for judging the degree of applicants' bodily damage from the use of humidifier disinfectants. As a result, this medical-scientific approach is becoming increasingly criticized by patients' organizations mainly composed of rejected applicants. Based on the analysis of the limits of this medical-scientific approach and after clarifying the social implications of the disaster from a sociological perspective, this paper proposes certain social approaches focused on participatory governance as a means of dealing with the current issue. Finally, the paper emphasizes that the act of taking social responses to the humidifier disinfectant disaster should also be considered a process of enlarging and deepening democracy in Korea.

A Framework of Medical Tourism as a Niche Trade Item: A System Approach

  • Kho, Tae-Gyou
    • Journal of Korea Trade
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    • v.25 no.2
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    • pp.1-21
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    • 2021
  • Purpose - The purpose of this research is to develop two medical tourism system models which explain medical tourism phenomenon with a systemic approach. Design/methodology - This research was conducted by using a qualitative data analysis which mainly refers to previous references of medical tourism in the areas of tourism and medicine. Leiper's tourism system model was utilized as a conceptual framework. In-depth interviews with experts in the field were conducted in order to pretest the models. Findings - This research suggests a medical tourism system framework and a medical service provision framework. The first model presents medical tourism components and their relationships within a framework presented in a diagram. The second model shows the relationships among medical services required by medical tourists, the service providers, and service human resources along with movements of medical tourists. Originality/value - The first model presents a spatial composition of medical tourism components and their relationships, whereas the second model shows the linkage among medical services, the service providers, and relevant service human resources along with time sequential steps of medical tourists. These two models are complementary and may be used as useful tools to observe medical tourism phenomenon with a systemic and holistic approach. These two models may enable stake holders avoid unnecessary confusions and conflicts that result in duplication of government policies and a waste of budget and human resources.

Surgery for Diaphragmatic Hernia Repair: A Longitudinal Single-Institutional Experience

  • Siwon Oh;Suk Kyung Lim;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Jhingook Kim;Young Mog Shim;Junghee Lee
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.171-176
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    • 2023
  • Background: This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach. Methods: After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed. Results: Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH. Conclusion: The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.

Surgical Ligation of Patent Ductus Arteriosus Using the Descending Aortic Approach in Two Dogs

  • Kim, Dae-Hyun;Hong, Sung-Hwa;Myung, Hyunwook;Son, Dong-ju;Nam, Aryung;Jung, Sung-Yong;Hwang, Jung-Yeon;Jee, Hyun-Choul
    • Journal of Veterinary Clinics
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    • v.37 no.1
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    • pp.42-45
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    • 2020
  • Surgical ligation is the treatment of the choice in patients with patent ductus arteriosus (PDA). This case series presents two cases of PDA, one with and one without persistent left cranial vena cava (PLCVC), treated with surgical ligation through the descending aortic approach with mini-thoracotomy. There were no specific complications during the surgical procedures. The descending aortic approach would be an alternative method for dissection of the PDA.

Mini-Bentall Surgery: The Right Thoracotomy Approach

  • Jawarkar, Manish;Manek, Pratik;Wadhawa, Vivek;Doshi, Chirag
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.554-557
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    • 2021
  • Surgeons are increasingly using the right mini-thoracotomy approach to perform aortic valve surgery. This approach has shown better results in terms of blood loss and length of hospital stay than the sternotomy approach. For selected patients requiring aortic root and ascending aorta surgery, a right mini-thoracotomy approach may prove beneficial. In our technique, we placed a 5-cm horizontal skin incision in the right second intercostal space. Femoro-femoral cardiopulmonary bypass was established. A valved aortic conduit was used for aortic root replacement. The patient's postoperative course was uneventful, with a short hospital stay. This technique offers a minimally invasive approach to aortic root and ascending aorta surgery with easy adaptability and reduced costs.

Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block

  • Kong, Yu Gyeong;Shin, Jin Woo;Leem, Jeong Gill;Suh, Jeong Hun
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.396-400
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    • 2013
  • Conventional transcrural CPB via the "walking off" the vertebra technique may injure vital organs while attempting to proximally spread injectate around the celiac plexus. Therefore, we attempted the CT-simulated fluoroscopy-guided transdiscal approach to carry out transcrural CPB in a safer manner, spreading the injectate more completely and closely within the celiac plexus area. A 54-year-old male patient with pancreatic cancer suffered from severe epigastric pain. The conventional transcrural approach was simulated, but the needle pathway was impeded by the kidney on the right side and by the aorta on the left side. After simulating the transdiscal pathway through the T11-12 intervertebral disc, we predetermined the optimal insertion point (3.6 cm from the midline), insertion angle (18 degrees), and advancement plane, as well as the proper depth. With the transdiscal approach, we successfully performed transcrural CPB within a narrow angle, and the bilateral approach was not necessary as we were able to achieve the bilateral spread of the injectate with the single approach.

Transvenous proximal closure of large congenital coronary arteriovenous fistula using the single Amplatzer vascular plug in a 3-year-old girl

  • Jang, Hae In;Choi, Young Earl;Cho, Hwa Jin;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.56 no.2
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    • pp.90-93
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    • 2013
  • Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.