• Acute and Critical Care
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• v.33 no.4
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• pp.252-259
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• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.379-388
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• 2000

Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.697-701
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• 2018

Background and Objectives The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. Subjects and Method From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. Results Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). Conclusion The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.351-359
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• 1991

The current LINAC technique for radiosurgery utilizes a single isocenter approach with multiple noncoplanar arcs. This approach results in spherical dose distributions in the target. Many arteriovenous malformations and tumors suitable for radiosurgical treatment have non-spherical or irregular shapes. The basic approach presented in this paper is to use two or multiple isocenters with standard arcs to shape irregular target volumes through the use of multiple spherical targets. Selection of reasonable irradiation parameters in the first stage is critical to the success of real-time optimization. A useful guideline for optimum isocenter separation and collimator size is developed to shape the target margin uniformly with an desired isodose surface for an elongated target. The implementation of multiple isocenters with three dimensional dose model and application of multiple isocenters approach to several cases are discussed.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.53-65
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• 1998

The main purpose of this paper is to analyze the modes of therapeutic intervention. The emphasis is on the neurophysiological perpective arising out of neurological principles and developmental concepts. The obtained results are as follows. 1. The important hypostheses predicted that the group intervened by neurodevelopmental approach would improve motor function better than the group done by traditional approach and it was proved that neurodevelopmental approach was more effective in gross motor region(P<.01) 2. In the comparison of type of involovement, neurodevelopmental intervention group in spastic type showed improvements in the region of gross motor.(P<.001) 3. In the comparision of degree of disorder, neurodevelopmental intervention group showed improvement of motor function in all the gross motor region in the mild, moderate and severe case.(P<.001) 4. In the comparison of ages of intervention beginning, the group of child between 25-36, 49-60 and 61-72 months(P<.001) intervened by neurodevelopmental approach showed improvements of motor function. 5. In the comparison of intervention duration, neurodevelopmental intervention group showed improvements of motor function in gross motor region according to intervention durstion(P<.001)

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.33-41
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• 2020

Objectives The purpose of this report was to study the circulation of meridian WiGi, YoungGi, from the viewpoint of manual medicine. Methods First, the Korean Medical approach analyzes documents about the circulation of meridian WiGi, YoungGi, and the biomechanical approach is to analyze documents about kinetic force and kinematic movement. The third inherent energy approach is to analyze documents about craniosacral rhythm and visceral motility. Finally, it is to study the correlation between the circulation of meridian WiGi, YoungGi, and the viewpoint of biomechanics force and movement, the inherent energy of manual medicine. Results Meridian WiGi is fast, powerful, and changeful. It circulates through the head and extremities in the daytime and visceral organs at night. The deviation pelvis and distorted thoracic cage create kinetic force and kinematic movement. Meridian YoungGi is very small and soft energy and circulates meridians and visceral organs permanently. Craniosacral rhythm and visceral motility radiate continuously from cranial and visceral organs to the whole body. Conclusions Circulation of meridian WiGi is closely related to the biomechanical approach. In addition, circulation of meridian YoungGi is closely related to the inherent energy approach.

• Korean Medical Education Review
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• v.16 no.1
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• pp.32-41
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• 2014

The purpose of this study was to investigate the differences in non-cognitive factors, specifically achievement goal orientation (AGO) and self-regulated learning (SRL), influencing the academic achievement (AC) of medical and nursing students. 186 students, including 110 medical students and 76 nursing students, completed a survey, which addressed the factors of AGO and SRL. There were significant differences in the factors that affected the academic achievement of medical and nursing students. Multiple regression revealed that the AC of medical students was significantly more affected by mastery-approach AGO (p<0.05), seeking information (p<0.001), and rehearsing/memorizing SRL (p<0.01), while the AC of nursing students was affected by performance-approach AGO, self-efficacy (p<0.001), and time-management SRL. Analysis of variance revealed that significant differences in the sub-factors of AGO and SRL between the medical and nursing students. Thus, it was found that the academic achievement of medical and nursing students was influenced by non-cognitive factors, but there were significant differences in the sub-factors by group. It is suggested that comparative studies with other student groups and a longitudinal study of medical and nursing students need to be conducted, and a personalized counseling and learning intervention focusing on non-cognitive factors should be provided to medical and nursing students.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.183-187
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• 2012

The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.93-97
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• 2021

Background: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon. Methods: Seven upper limb specialists, two general orthopedic specialists, and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye. Results: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral. Conclusions: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.3
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• pp.15-22
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• 2014

Backround : The paradigm of recent education has been shifting from existing style of professor-oriented, passive and rote teaching to learner-centered education. Rather than mere delivery of knowledge, today's idea of education uses various audiovisual media to let learners gain more problem-solving skills, judgment, cognitive thinking ability, and creativity to apply to real practice. Also, while current trends and change in policy ask for related industry to require practice-centered teaching learning model, Problem-Based Learning (PBL) is quite effective that it activates problem-solving skills as well as application of National Competency Standards (NCS). Purpose : The purpose of this study was to suggest a teaching learning model article as an approach to apply web-based PBL for patient & medical charge management practices. Discussion & Conclusion : This paper the cases on PBL and presents the teaching learning model on web-based PBL as an approach to applying web-based PBL, which fits Medical Information System Department that combines health-medical treatment and computer applications, to practical health administrative affairs.