• 한국의료질향상학회지
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• 제8권1호
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• pp.84-94
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• 2001

Background : in order to adapt to changes of the medical environm interests that is drawn in ambulatory surgery are increased as a method of approaching a patients' satisfaction and cost-effective management. The purpose of this study is to a assess the operation which is able to perform through ambulatory care unit, to identify the problem in ambulatory surgery, and to increased the opportunity of ambulatory surgery with safety. Methods : Between May 13th, 1998 and June 30th, 2000, we performed surgical treatment through ambulatory care unit, and evaluate the results of them. The sorts of operation, duration of stay in the hospital, total cost of treatment, satisfaction of patients and safety if anesthesia were assessed. Results : We performed ambulatory surgery without serve complications and the patients were satisfied with surgical treatment through ambulatory care unit. In comparison of ambulatory and admission surgery, there was a reduction of cost to 16.7~25.3% in ambulatory surgery. Also, the duration of admission was 2 days shorter than admission surgery. Conclusions : According to our results, the surgical treatment through ambulatory care unit is safe and useful method that increase the quality of medical service, satisfaction of patients and reduce the cost of treatments.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제16권1호
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• pp.35-42
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• 2010

As a functionally complicated facility, it requires rational strategy to accommodate multi-functional needs to plan a hospital. Ambulatory surgery units located in large hospitals have problems such as longer waiting time and congestion for patients due to complicated planning and organization within limited area, which raise needs for independent ambulatory surgery centers to enable smoother medical treatment for patients. To design an independent ambulatory surgery center, understanding of zoning and layout of each unit needs is particularly required. This study focuses on research of efficient zoning/organization of day surgery unit and circulation arrangements of ambulatory surgery centers by analyzing various examples abroad, which will eventually help finding appropriate way of planning domestic ambulatory surgery centers. Specific area of research includes ambulatory surgery process, programmatic requirements, spatial organization of the facility, layout of surgery unit and circulation arrangements of ambulatory surgery centers.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제1권2호
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• pp.7-16
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• 1996

As surgical technologies advanced, ambulatory surgery was proposed for reduction hospital stay and patient-oriented health care delivery system. And in recent years, ambulatory surgery is also introduced in this country as medical demands expands. This study aims to represent the standards for architectural planning of the ambulatory surgery center in a general hospital according to domestic situations. For this, the present conditions and space programs of 5 general hospitals were investigated and analyzed. This study also aims to represent the unit area proposal of each departmental operation room and the methodology for deciding the number of the operation threatres in Ambulatory Surgery Center.

• 한국병원경영학회지
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• 제4권2호
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• pp.41-59
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• 1999

Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.136-141
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• 2008

Background and Objectives: Laryngopharyngeal reflux (LPR) is a very common disease among outpatients of department of otorhinolaryngology. Although there are several diagnostic tools for LPR disease and ambulatory 24-hour double-probe pH monitoring is gold standard method, empirical diagnosis by reflux symptom index and reflux finding score (RFS) are mainly used. So we analyzed the relationship between ambulatory 24-hour double-probe pH monitoring and RFS in patients with LPR. Subjective and Method: Fifty patients with LPR symptoms and abnormal RFS and ambulatory 24-hour double probe monitoring were enrolled. Each items and sum of laryngeal reflux score were compared the results of ambulatory 24-hour double-probe pH monitoring in upper (UES) and lower (LES) esophageal sphincter. Results: There were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES (pH<4 and pH<5) and each item and sum of RFS. However, supine time and reflux number of UES (pH<5) were showed the partial correlations with diffuse laryngeal edema and thick endolaryngeal mucus (p=0.03, p=0.01). Although there were no relationship between the results of ambulatory 24-hour double-probe pH monitoring in LES and sum of RFS, the significant correlations presented between granuloma and total time (p=0.008), upright time (p=0.008, reflux number (p=0.049) of LES. Conclusion: Although granuloma among items of RFS showed significantly correlation with the results of ambulatory 24-hour double-probe pH monitoring in LES, there were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES and LES and items and sum of RFS.

• Journal of Korean Biological Nursing Science
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• 제6권1호
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• pp.43-52
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• 2004

Purpose : The purpose of this study was to find effects of early oral water intake on thirsty feeling, nausea, and vomiting after ambulatory surgery. Method : Sixty patients who received PET(Pressure Equalizing Tube) insertion surgery under general anesthesia were conveniently sampled and divided into two groups. Experimental group was instructed to drink water after two hours and control group was directed to intake water after three hours postoperatively. Data were collected from May 1, 2002 to August 31, 2002 at ambulatory surgery center of Asan Medical Center. The thirsty feeling, nausea and vomiting score between experimental and control group were compared at the time of recovery, recovering consciousness, 2hr, 3hr, right before discharge and/or 24hr(telephone interview) postoperatively. The collected data were analyzed by SPSS 8.0 statistic program. Result : Result of this study are as follows. 1) There was a statistically significant difference(t=-10.31, p=0.00) in the occurrence of thirsty feeling at the 3hr postoperatively between experimental and control groups. 2) There was a statistically significant difference($x^2=6.66$, p=0.02) in the incidence of nausea during the 2hr postoperatively between experimental and control groups. 3) There was no difference($x^2=0.35$, p=0.55) between groups in vomiting scores. Conclusion : It was generally known that the delay of oral water intake decreases post operative complications. But, this study shows that early oral water intake decreases discomfort of thirsty and there was no adverse effects on the occurrence of postoperative nausea and vomiting.

• 임상간호연구
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• 제18권3호
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• pp.435-446
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• 2012

Purpose: This study was conducted to compare three discharge criteria; 1) discharge criteria of S Hospital determined by nurses, 2) discharge readiness determined by patients, and 3) the Modified Post-Anesthetic Discharge Scoring System (MPADSS). The usefulness of MPADSS as a discharge criteria for the patients'safe return to home after ambulatory surgery was also evaluated. Methods: A total of 370 day surgery cases were investigated. The MPADSS was employed in every 30 min. in parallel with discharge readiness assessment by nurses and patients. The percentage of the patients who were categorized as being ready to discharge were compared according to three discharge criteria. Results: The percentage of patients scored to be as MPADSS > 9 in 30 min, 60 min, 90 min were 96.5%, 99.5%, 100%respectively. Whereas 11.1%, 44.3%, 71.1%of patients rated themselves as being ready to discharge and 2.7%, 23.5%, 54.3% of patients actually discharged by nurses according to discharge criteria of S Hospital. Conclusion: Nurses tend to keep patients longer in the hospital when compared to the patient's own assessment about their readiness to home and to that of MPADSS. Faster discharge in the evening than day time suggests patient discharge can be influenced by nursing factors. This brings out the importance of scoring system to determine the safe discharge. The MPADSS could be a useful tool in evaluating patients for safe discharge.

• 한국임상수의학회지
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• 제34권5호
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• pp.370-373
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• 2017

Sacroiliac dislocation is the separation of the iliac wing from the pelvic bone and needs to be repaired by surgery. Corrective surgical methods include open reduction and minimally invasive techniques. In the present study, we used a minimally invasive surgical technique in seven dogs with sacroiliac dislocation. Five cases had unilateral sacroiliac joint luxation and two cases had bilateral sacroiliac joint luxation; all were referred to hospital after being hit by an automobile. All cases were treated with a fluoroscope-assisted, minimally invasive technique. Patients were evaluated by measuring surgery time, postoperative ambulatory time, and calculating pelvic canal diameter ratios. Surgery time was measured from initial incision to completion of skin closure. Mean surgery time was 30.6 minutes in unilateral sacroiliac joint luxation and 68 minutes in bilateral sacroiliac joint luxation. Mean preoperative pelvic canal diameter ratio was 1.22 (${\pm}0.27$), immediate postoperative pelvic canal diameter ratio was 1.26 (${\pm}0.10$), and at 2 weeks after surgery, the pelvic canal diameter ratio was 1.37 (${\pm}0.22$). All cases were ambulatory within 1 week and mean postoperative ambulatory time was 5 days. Based on the results, the use of a minimally invasive technique for correction of sacroiliac dislocation can decrease surgical time, lessen operative and postoperative burdens on patients, and provide owners with a good prognosis.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.448-453
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• 2015

Objective : Recently, the survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and medical treatment modalities. Consequently, spine metastases from HCC are being diagnosed more frequently. The accurate prediction of prognosis plays a critical role in determining a patient's treatment plan, including surgery for patients with spinal metastases of HCC. We investigated the clinical features, surgical outcomes, and prognostic factors of HCC presenting with spine metastases, in patients who underwent surgery. Methods : A retrospective review was conducted on 33 HCC patients who underwent 36 operations (three patients underwent surgical treatment twice) from February 2006 to December 2013. The median age of the patients was 56 years old (range, 28 to 71; male : female=30 : 3). Results : Overall survival was not correlated with age, sex, level of metastases, preoperative Child-Pugh classification, preoperative ambulatory function, preoperative radiotherapy, type of operation, administration of Sorafenib, or the Tokuhashi scoring system. Only the Tomita scoring system was shown to be an independent prognostic factor for overall survival. Comparing the Child-Pugh classification and ambulatory ability, there were no statistically differences between patients pre- and post-operatively. Conclusion : The Tomita scoring system represents a practicable and highly predictive prognostic tool. Even though surgical intervention may not restore ambulatory function, it should be considered to prevent deterioration of the patient's overall condition. Additionally, aggressive management may be needed if there is any ambulatory ability remaining.