• Archives of Plastic Surgery
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• 제38권4호
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• pp.421-426
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• 2011

Purpose: Although the sural nerve is the most commonly used donor for autologous nerve graft, its morbidity after harvesting is sparsely investigated. The sural nerve being a sensory nerve, complications such as sensory changes in its area and neuroma can be expected. This study was designed to evaluate the donor site morbidity after sural nerve harvesting. Methods: Among the 13 cases, who underwent sural nerve harvesting between January 2004 and August 2009, 11 patients with proper follow up were included in the study. The collected data included harvested graft length, actual length of the grafted nerve, anesthetic and paresthetic area, presence of Tinel sign and symptomatic neuroma, and scar quality. Results: In 7 patients, no anesthetic area could be detected. Of the patients with a follow up period of more than 2 years, all the patients showed no anesthetic area except two cases who had a very small area of sensory deficit ($225mm^2$) on the lateral heel area, and large deficit ($4,500mm^2$) on the lateral foot aspect. The patients with a short follow up period (1~2 m) demonstrated a large anesthetic skin area ($6.760mm^2$, $12,500mm^2$). Only one patient had a Tinel sign. This patient also showed a subcutaneous neuroma, which was visible, but did not complain of discomfort during daily activities. One patient had a hypertrophic scar in the retromalleolar area, whereas the two other scars on the calf were invisible. Conclusion: After a period of 2 years the size of anesthetic skin in the lateral retromalleolar area is nearly zero. It is hypothesized that the size of sensory skin deficit may be large immediately after the operation. This area decreases over time so that after 2 years the patient does not feel any discomfort from nerve harvesting.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제18권3호
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• pp.29-39
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• 2012

Window and shading designs have a great influence on energy consumption and daylighting in buildings. As far as energy is concerned, small window area is advantageous. But it is not good to the patient healing in hospital. So it is important to find out the optimum window shape which is favorable for both energy consumption and patient healing. In this study, annual energy consumption and daylight illumination levels were analyzed according to the window shapes and shading devices for a multi-beded patient room in hospitals. The simulations were conducted for 19 different cases by COMFEN 4.0 computer simulation program. The results of this paper are as follows. First, window to wall area ratio and shading devices have great influences on annual energy consumption. But it is a problem in that they decrease significantly daylight level in bed room. Second, considering the same energy consumption, reducing the width of window rather than the hight of window is desirable for the secure of daylight level. Third, increase of the number of horizontal shade is not desirable in south face of the building for the energy consumption and daylight level. Fourth, sun shade is not necessary in north face of the building for the energy consumption and daylight level.

• 한국응급구조학회지
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• 제24권3호
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• pp.147-154
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• 2020

Purpose: The purpose of the study was to investigate traumatic urethral injury in a 63-year-old patient with hematuria. Methods: A hematuria patient was transferred by paramedics. At the time of the visit, the patient's blood pressure (151/91mmHg), pulse rate (86/min), body temperature (37.1℃), and other vital signs were stable. Their KTAS (Korean Triage and Acuity Scale) was Level 4. The patient had no damage to the injured area, but a large contrast defect was observed between the prostate urethra and the bladder in urethral angiography performed due to persistent hematuria and pain in the injured area. Results: Following radiological evaluation of a suspected liposarcoma or neuroma mass of the prostate urethra, the mass was removed through urethral tumor resection. The result of histologic evaluation provided a diagnosis of highly differentiated invasive urethral cell carcinoma that had invaded the muscle layer. The patient was given additional treatment for urethral cancer but was rejected and is currently being followed. Conclusion: The prognosis for urinary tract cancer has distinct differences for patients with lymph node metastasis and tumor characteristics. The presence or absence of urethral cancer should be confirmed through angiography, CT, MRI, and cystoscopy.

• 한국간호교육학회지
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• 제8권1호
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• pp.29-37
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• 2002

This study was performed to investigate the level of importance and performance of patient education perceived by patients and nurses. The subjects consisted of 108 patients and 106 nurses in one university-affiliated hospital in Daegu, from February 1 to February 5, 2002. Data were collected through self-report questionnaires which were constructed to include the level of importance and performance of patient education. The data were analyzed by an SPSS program. 1) The level of importance of patient education perceived by patients and nurses was high, but the level of performance of patient education was relatively low. The level of importance and performance of patient education perceived by patients and nurses ranked as the highest in the area of diagnosis and treatment. 2) The level of importance and performance of patient education perceived by patients was not different according to general characteristics. The level of importance and performance of patient education perceived by nurses was different according to age and the working unit and the level of performance of patient education was different according to clinical career and job position. These results suggest that the level of importance of patient education perceived by patients and nurses was different to the level of performance of patient education perceived by them. Therefore nurses should actively provide patients with the educational program based on the importance of patient education perceived by patients.

• 보건행정학회지
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• 제25권3호
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• pp.174-184
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• 2015

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.

• 대한치과의사협회지
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• 제37권4호통권359호
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• pp.279-286
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• 1999

In patients with severely atrophic mandibular posterior area, implant placement is a problematic surgical procedure. Inferior alveolar nerve transpositioning technique offers better initial stability of implant and reduce the risk of permanent nerve damages. In this case report, the patient has bilateral atrophic mandibular posterior edentulous area. We placed 3 implants on each mandibular posterior area in conjunction with bilateral inferior alveolar nerve transpositioning to achieve sufficient bone height. The patient complained of paresthesia in lower lip and chin area and ptosis of lower lip after surgery. Neurosensory function was normal in 10 weeks after surgery.

• 대한간호
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• 제5권2호통권22호
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• pp.20-29
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• 1966

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권2호
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• pp.57-64
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• 2021

Purpose: The relationship between the staff area and the patient's private area is the key factor in designing the structure and the environmental characteristics of ward spaces in a psychiatric hospital. Recent research has found that for the purpose of treatment and securing privacy, psychiatric patients need to be in an open space of relief rather than closed confined environment and under the watch of nursing staffs. Methods: A survey at three kinds of wards in a private psychiatric hospital in Japan was conducted in October 2002. These wards include an acute ward, a psychiatric convalescence ward, and a stress care ward. All three kinds of wards have the same structure. At each ward, spatial preferences of the 145 psychiatric inpatients were surveyed and data concerning the patient's diagnostic category, symptoms, and activities of daily living were recorded. Results: The patients in the stress care ward prefer to stay in private spaces than public spaces. On the other hand, in the acute ward the patients seem to have a preference between managed public spaces where are monitored by nursing staffs and their private rooms where the nurse station is close. In addition, the patients in the psychiatric convalescence ward spend most of their time in the public space, such as the hallways or the day room. Implications: Base on this research, the spaces at the acute ward that could be monitored by the nursing station serves effectively as a safety space for patients was concluded. However, in the stress care ward, the patients may perceive the monitoring by the nursing staff as interruption or nuisance to their relaxation. In order to design an ideal healing environment for psychiatric patients in psychiatric ward, it is important to consider how environmental characteristics of space affect the environmental sense of patients in each ward.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제1권2호
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• pp.39-51
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• 1996

Design scheme drawings of the two major corporate hospitals - Asan Medical Center and Samsung Medical Center - are analysed in the aspect of floor area distributions and their proportions for various users and user-functions. Primary users of hospitals are categorized into three ; patients, employees and others. Then, patient spaces are subdivided into patient private, patient/medical, patient/support staff, patient/nursing, patient/guardian, patient common ; employee spaces into doctors, trainees, doctors common, nurses, support staffs, non-medical staffs, employee common ; others spaces into subcontractors, general publics, non-living, and internal circulation. The purpose of this research is to develop a user-focused insight into hospital spaces and a new method of hospital programming and design.

• 대한영양사협회학술지
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• 제22권1호
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.