Purpose: We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. Materials and Methods: From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. Results: The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Conclusion: Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.
Journal of The Korean Digital Architecture Interior Association
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v.11
no.4
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pp.5-11
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2011
The present study investigated the actual conditions of physical therapy rooms at long-term hospitals in Korea and conducted a comparative analysis to develop an efficient floor plan and facility improvement measures. 1. At hospitals surveyed, physical therapy services were used at a high frequency but they did not have enough space for rehab treatment and long paths of patient flow were found to make patient management inconvenient. Therefore, physical therapy units should be conveniently located both in terms of distance and direction so as to be accessible from patient rooms or wards. The space should be organized in a concentrated layout for efficiency of physical therapy, and floor planning for therapy units should ensure the best possible viewing angle to therapists. 2. With regard to the disease characteristics of patients, many physical therapy rooms were in difficult circumstances because of poor facilities, so they need to secure skilled personnel, supplement apparatuses and equipment and have rooms for functional recovery, hydrotherapy and operation treatment. In addition, each of the curtained or partitioned areas for treatment should be set up with consideration for the amount of space taken up by medical equipment. The area under each bed should be designed for patient convenience so that it can be used as storage space for patient's belongings and shoes. 3. Patients complained about the lack of physical therapy space, resting places or exercise areas and demanded the expansion of rehab programs and facilities. Physical therapy facilities need to be improved for patient privacy and effective natural ventilation. 4. At most of the long-term hospitals surveyed, physical therapy units were found to have small areas and treatment equipment and devices were insufficient compared to the number of patients. Therefore, it is required to secure more space (at least 138.24 sq. meters per 100 beds) and improve facilities for better physical therapy services.
The Journal of the Institute of Internet, Broadcasting and Communication
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v.17
no.3
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pp.183-188
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2017
This paper is for the a study on home healthcare system for a patient using SAW Tag. This system is useful when there's a patient in home. Many patients are wounded in restroom. But restroom is very private place and nobody want to be disturbed here. The place where the patient is most injured in the house is the toilet, and it is the point where the privacy of the individual should be kept and the patient's condition should be checked and cope with in case of emergency. And using saw tag, we can calculate position and ID through reflected rf signal. Therefore we propose a general home healthcare system. The management system utilized a seat bed system to monitor at-home patients. The system mounts a bio-signal measuring unit on a toilet seat, measures a bio-signal from the bio-signal measuring unit, and the measured bio-signal is transmitted to the main server through the user's smart phone. With proposed system, we can expand operation area to silver town where many patients are cared. In this paper we developed sensor system and saw tag positioning system and showed the result.
Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.
The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.
This study is an attempt to analyze the physical load by the type of the nursing tasks at the neurosurgical ICU nurses through the quantitative analysis of the working postures by the type of the nursing tasks with the OWAS(Ovako Working Postures Analysis System). Data collection was conducted through the video recording of the 13 nurses working at the neurosurgical ICU. For the analysis of the work postures by the type of the nursing tasks, and were interviewed regarding the subjective degree of the difficulties with the work postures related to the tasks. Collected data was analyzed through the WinOWAS program. The results were as follows : AC3 or AC4 tasks among the 18 nursing tasks types are "occupied bed making and change of the patient gown", "back massage", "suction", "elimination management", "change of position", "adjustment of bed", "helping the patient to move","measurement of CVP"and "measurement of urine volume". It appears that these tasks are harmful to the musculoskeletal system and the improvement or change of the work is required. The results stated above indicate that improper working postures during the nursing tasks influence the musculoskeletal system. Therefore, making use of assistant devices for the improvement of the working environment at the nursing tasks, based on human technological diagnoses, is required regarding the duty types with massive work pressure known to be harmful to the musculoskeletal system among those performed by the nurses. And there is a need of the education about the employment and maintenance of the vocational back pain prevention.
Kim, Ji-Hyoung;Ha, Ho-Wook;Lee, Hae-Jong;Sohn, Tae-Yong
Korea Journal of Hospital Management
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v.10
no.3
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pp.45-66
/
2005
The purpose of this study was to analyze related factors affecting profitability on general hospitals(300-499 beds). The data were derived from survey by the Korean Hospital Association on 33 hospitals during 10 years (from 1993 to 2002). Profitability was measured by 3 ratios - net profit to total assets, normal profit to total assets and operating margin to gross revenue - as dependent variables. Independent variables were classified by general factors (ownership, number of bed, period of establishment, region), financial factors (total asset turnover, current ratio, liabilities to total assets, personnel costs per operation profit, material costs per operation profits), productivity index(number of daily patient per nurse), the score of quality assurance activity and the time lag score. Multiple regression model was used in this study. First, Number of bed, region was not statistically significant for profitability. But ownership was affect positively to normal profit to total assets and operating margin to gross revenue. Private hospitals had higher profitability than that of public hospitals Second, the score of quality assurance activity was not statistically significant to profitability. Third, Those hospitals having more daily patient per nurse had significantly higher profitability than the others. Fourth, Those hospitals having higher proportion in total asset turnover had significantly higher profitability than other hospitals. But liabilities to total assets and liquidity ratio had no difference to the profitability. Those hospitals having higher proportion in personnel costs and material costs per operation profits had significantly lower hospital profitability than others.
Lee, Hye Youn;Jung, Jin Young;Park, Se Yeon;Jo, Eun Mi;Jang, Chang Seob;Kim, Hyang Seon;Park, Mi Jeong;Hwang, Yu Min;Suh, Eun Young
Journal of Korean Clinical Nursing Research
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v.25
no.1
/
pp.91-97
/
2019
Purpose: The purpose of this study was to investigate hemato-oncology patients' discomfort and bleeding in relation to the bedrest time after bone marrow examination. Methods: A descriptive correlational study was conducted. The data were collected using self- report questionnaire from total of 131 patients who underwent bone marrow examination from January 2017 to September 2017. Data were analyzed with descriptive statistics, Wilcoxon Signed-rank test, McNemar's test and logistic regression. Results: The level of discomfort after 4 hours of bedrest was significantly higher when compared to 2 hours of bedrest(p<.001). The occurrence of bleeding after 2 hours of bedrest was significantly higher than 4 hours of bedrest(p<.001), however the degree of bleeding was slight. No bleeding occurred in 84% of the patients after 2 hours of bedrest. Conclusion: The results of this study demonstrated that shortening the bed rest time after bone marrow examination was helpful in improving the patient's well-being. Bedrest time could be shortened according to the site of bone marrow examination and patient's condition.
Young Hwii Ko;Jong Gyun Ha;Jae Yoon Jang;Yeung Uk Kim
Journal of Yeungnam Medical Science
/
v.41
no.1
/
pp.48-52
/
2024
While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.
Demands for geriatric hospital have increased in an era of rapidly aging population. Most of aged patients tend to stay in institutions for long terms. This means that the patient rooms of geriatric hospital should be given different considerations from those of normal hospital in designing interior features. They should be a homelike places for the aged patients and designed to take care of specific needs of the aged. However, most of geriatric hospitals are designed with little attention to such point. They appear almost same to normal ones. This study attempts to examine how users evaluate patients' rooms. The users are nurses, care-givers and family members of aged patients in six geriatric hospitals in Busan. They rated 12 features of patient rooms from 0 point to 100 points and described reasons why they rated in that way. Also, the walk-through was done for these six hospitals. 12 features are sizes of patient rooms, sizes and fixtures of bathrooms, sizes and locations of windows, bed layout, numbers and types of chairs, sizes and types of closet, lighting, color scheme, finishes of floor and wall, and interior design tone. Followings are findings : The users evaluated patients' rooms relatively positive. However, extra chairs for visitors, closet in patients rooms and storage in bathroom, and sizes of patients rooms and bathrooms were evaluated relatively negative.
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