• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1612-1619
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• 2000

Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.1-10
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• 2016

Objectives : The purpose of this study was to review the effectiveness of Chuna manual therapy for the treatment of tension type headache(TTH). Methods : All processes were independently carried out by three investigators. Literature search was performed in 3 databases(pubmed, OASIS, NDSL) from their inception to May 2016. Searched reports was twice excluded for title, abstract and body. And then, data extract and analysis was done before assessing risk of bias by Cochrane Handbook. Results : 11 RCT were included. Generally, Fascia Chuna therapy and Chuna spine & joint manipulation therapy were used for TTH. Except for 1 report, Chuna manual therapy was shown to be effective in treating TTH. In assessing risk of bias, because of the characteristic of intervention, blinding of participants was high risk of bias in most reports. Conclusions : Chuna manual therapy was shown to be effective in treating TTH. In korea, better designed trials with high quality is needed from now on.

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.769-776
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• 2003

Purpose : The survival rate of very low birth weight infants(VLBWI) has improved by virtue of specialized neonatal care. This study was performed to analyze the changes in incidence, survival rate and morbidity of VLBWI who admitted to Chonnam National University Hospital from 1996 to 2001. Methods : We enrolled 565 VLBWI, and compared the incidence and the survival rate according to the birth weight or gestational weeks between period I(1996 to 1998) and period II(1999 to 2001). The mortality rate according to the postnatal age, cause of death, morbidity and days of hospital stay were also compared. Morbidity is categorized into 'short term' which is curable until discharge, and 'long term' causing any types of sequelae after discharge. Results : Incidence of VLBWI significantly increased in period II over period I(6.0% vs. 11.0%, P< 0.001). The survival rate also increased in period II(71.8% vs. 80.1%, P<0.05), especially in 1,000 to 1,249 gm of birth weight(P<0.001) and in 28 to 30 weeks of gestation(P<0.001). The most common cause of death was respiratory distress syndrome in period I; however it was sepsis in period II. Although overall and short term morbidity rate increased, long term morbidity and days of hospital stay didn't increase in period II. Conclusion : Although the incidence of VLBWI significantly increased and the survival improved in period II compared to period I, especially in 1,000 to 1,249 gm of birth weight and 28 to 30 weeks of gestation, 'long term' morbidity rate and hospital days didn't increase.

• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.973-979
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• 2000

A glycogen storage disease(GSD) type I is a metabolic disease caused by a deficiency in one of the components of the glucose-6-phosphatase(G-6-Pase) system. This disorder results in hypoglycemia, hepatomegaly, lactic acidemia, hyperlipidemia, and hyperuricemia. Comon long(-)term complications include growth retaradation, gout, hepatic adenomas, osteoporosis and renal disease. However the cardiovascular system is rarely involved, and only six cases of pulmonary hypertension associated with GSD I have been reported in the literature. We experienced a case of pulmonary hypertension with type I GSD. A 31-year-old rnan, who had discovered type I GSD and received portocaval shunt operation 22 years ago, was admitted to the hospital with the chief complaint of dyspnea. Echocardiographic examination and cardiac catheterization revealed severe pulmonary hypertension. Nitric oxide and oral prostacycline derivative(beraprost) were tried without acute favorable response. After one year with beraprost, dyspnea, exercise capacity and hemodynamic parameters were improved. We report this case with a review of the literature.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

• Journal of Venture Innovation
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• v.5 no.1
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• pp.145-154
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• 2022

This study briefly compares the first-cycle certification of nursing hospitals with the second-cycle certification, reviews the changes and achievements of the second-cycle certification and the third-cycle certification, and examples of challenges and solutions in the process of preparing the third-cycle certification. In this study, it is suggested as follows. First, in order to see the practical effect of certification intended by the government, the exhibition is prepared in a short period of time before certification. Second, after the implementation of the nursing hospital certification system, research on the hospital performance of the medical institution certification system is insufficient in terms of quality and quantity. Therefore, in order to see the effect on the certification system, various research support is also required so that research on this can be actively conducted. Third, design certification standard guidelines from a long-term perspective so that the standard guidelines for certification do not change significantly, and certify not only the guidelines but also individual standards and forms that can be used by medical institutions. Fourth, in the four-cycle certification, accurate and realistic guidelines for infection control and quarantine ward operation support should be developed. The importance of managing infectious diseases will be highlighted in the future due to COVID-19. Fifth, medical institutions can improve the quality of medical care in nursing hospitals and have competitiveness if their daily activities, not short-term certification preparation, are carried out in accordance with certification standards, which affects performance. Sixth, when preparing for certification, nursing hospital officials have problems in organizing documents or processing administratively in the short term as in the past. This is also based on the certification criteria for the usual business process.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.18-27
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• 2009

Purpose: This study is to provide effective care to each individual with myocardial ischemia by finding out how the patient's knowledge related to the disease and anxiety level affect his/her compliance of patient role behavior. Methods: The subjects of study were 100 patients diagnosed as ischemic heart disease at a university hospital located in Gyeonggi Province. The data were collected from May 19, 2008 to August 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaires. Results: The average score of knowledge level about myocardial ischemia was $22.24\pm5.07$(out of 31), anxiety level was $54.68\pm9.15$(out of 80), and compliance of patient role behavior was $34.28\pm6.00$(out of 50). A significant correlation between the patient's level of knowledge and his/her compliance of patient role behavior was found(r=0.239 p=0.017). The patients who are females, singles, without occupation, have a long term being diagnosed, under-educated, tend to be excellent in their compliance. Conclusion: The patient with a higher level of knowledge is better in his/her compliance of patient role behavior. Therefore, it is suggested that we need to develop nursing intervention to increase knowledge level as well as consistent educational support.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.2
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• pp.75-79
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• 2007

Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.89-99
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• 2015

This study aims to develop a LOS(Length of Stay) bench-making system that can provide efficient by comparing the LOS management of other hospital and level evaluation for inducing the LOS to manage their own activities. The convergence LOS bench-making web program has been implemented to compare a variety of beds, regional group, followed reporting with excel files downloads by using the severity-adjusted LOS model of Korean National Hospital Discharge in-depth Injury Survey data. Features that are computed in real-time severity-adjusted LOS was also implemented. Trial operating results, bench-making system was confirmed efficient for management of LOS on the long-term care and group of disease in hospital from the staff or medical department, receive requests comparative statistics by area and disease group. Therefore the policy alternative on extension of severity-adjusted LOS is needed to utilized bench-making system on LOS.