• Journal of Trauma and Injury
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• v.26 no.4
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• pp.261-265
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• 2013

Purpose: The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type. Methods: Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review. Results: The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038). Conclusion: An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.502-508
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• 2022

Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.281-313
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• 2013

A physician has to do his best for the better treatment of his patiensts. But, if a physician cannot remedy his patients because of the lack of hospital facilities, the lack of medical knowledge and etc., the physician must transfer his patients to another suitable hospital immediately. This is called the duty of interhospital transfer of patients. The necessity of interhospital transfer of patients is primarily ocurred in emergency medical care situations. The Supreme Court Decision 2010DO7070 delivered on April 29, 2010 is one of the important decisions related to the duty of interhospital transfer of patients. The Supreme Court ruled that there were the physician's medical malpractice and the causation between the physician's medical malpractice and the death of patient, as the physician has left the patient without due observations for 1 hour and 30 minutes after the caesarean operation inspite of mass bleeding during the operation, and has transferred the patient to another suitable hospital later. And the Supreme Court ruled that the transferring physician has to explain the situation of the patient in detail to the physician being transferred. I agree with the Supreme Court Decision. As decided by the Supreme Court, physicians will treat their patients more carefully and in case of necessity for transfer, physicians will transfer their patients with more caustion. However, the study for this issue should be continued hereafter because concrete standards are not given to lawers and physicians just by the Supreme Court Decisions itself.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.2
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• pp.105-110
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• 2017

Objective: The purpose of this study was to evaluate the efficacy of frozen mixed double-embryo transfer (MDET; the simultaneous transfer of day 3 and day 5 embryos) in comparison with frozen blastocyst double-embryo transfer (BDET; transfer of two day 5 blastocysts) in patients with repeated implantation failure (RIF). Methods: A total of 104 women with RIF who underwent frozen MDET (n = 48) or BDET (n = 56) with excellent-quality embryos were included in this retrospective analysis. All frozen embryo transfers were performed in natural cycles. The main outcome measures were the implantation rate, clinical pregnancy rate, multiple pregnancy rate, and miscarriage rate. These measures were compared between the patients who underwent MDET or BDET using the chi-square test or the Fisher exact test, as appropriate. Results: The implantation and clinical pregnancy rates were significantly higher in patients who underwent MDET than in those who underwent BDET (60.4% vs. 39.3%, p=0.03 and 52.1% vs. 30.4%, p=0.05, respectively). A significantly lower miscarriage rate was observed in the MDET group (6.9% vs. 10.7%, p=0.05). In addition, the multiple pregnancy rate was slightly, but not significantly, higher in the MDET group (27.1% vs. 25.0%). Conclusion: MDET was found to be significantly superior to double blastocyst transfer. It could be regarded as an appropriate approach to improve in vitro fertilization success rates in RIF patients.

• Research in Community and Public Health Nursing
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• v.19 no.2
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

• The Korean Society of Law and Medicine
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• v.10 no.1
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• pp.389-420
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• 2009

Main Issue of Supreme Court Decision 2005Da16713 Delivered on June 24, 2005 is about the duty of medical care in the interhospital transfer of patients. According to the above Supreme Court Decision, in the interhospital transfer of patients, the decision to transfer should make from the aspect of medical treatment. The hospitals and doctors keep the duty of medical care. In addition to the duty for hospitals/doctors to check the capacity and availability of the hospital to which the patient is transferred, there are also duties to inform about emergency medical service and to sufficiently explain the need for the transfer, the medical conditions of the patient to be transferred and the hospital from which the patient is transferred. The hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer. including information upon referral, completeness of medical records, patient monitoring and so on. The interhospital transfer requires the consent of doctor belonging to the hospital to which the patient is transferred after the consideration of capacity and availability of the hospital and the informed consent of patients or legal representatives.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.9-15
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• 2019

Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. Results: Mean patient age was 55 years (range, 48-61 years), and mean follow-up period was 20 months (range, 12.0-27.2 months). Mean VAS score significantly improved from $6.6{\pm}2.6$ preoperatively to $1.8{\pm}2.5$ postoperatively (p=0.009), mean ASES score increased from $67.6{\pm}9.2$ to $84.6{\pm}15.1$, and mean UCLA score from $18.0{\pm}1.4$ to $28.8{\pm}8.5$ (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.122-128
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• 2019

Background The masseter nerve is a useful donor nerve for reconstruction in patients with established facial palsy, with numerous advantages including low morbidity, a strong motor impulse, high reliability, and fast reinnervation. In this study, we assessed the results of masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Methods Ten patients with facial palsy who received treatment from January 2015 to January 2017 were enrolled in this study. Three patients received masseter nerve-only free gracilis transfer, and seven received double-innervated free gracilis transfer (masseter nerve and a cross-face nerve graft). Patients were evaluated using the Facial Assessment by Computer Evaluation software (FACEgram) to quantify oral commissure excursion and symmetry at rest and when smiling after muscle transfer. Results The mean time between surgery and initial movement was roughly 167.7 days. A statistically significant increase in excursion at rest and when smiling was seen after muscle transfer. There was a significant increase in the distance of oral commissure excursion at rest and when smiling. A statistically significant increase was observed in symmetry when smiling. Terzis' functional and aesthetic grading scores showed significant improvements postoperatively. Conclusions Masseter nerve innervation is a good option with many uses in in established facial palsy patients. For some conditions, it is the first-line treatment. Free gracilis muscle transfer using the masseter nerve has excellent results with good symmetry and an effective degree of recovery.

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.172-180
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• 2016

Background Conventional frontalis transfer may cause a range of complications. In order to overcome complications, we made modifications to the surgical technique, and compared the outcomes of patients who underwent conventional frontalis transfer with those of patients who underwent modified frontalis transfer. Methods We conducted a retrospective study of 48 patients (78 eyes) who underwent conventional frontalis transfer between 1991 and 2003 (group A) and 67 patients (107 eyes) who underwent modified frontalis transfer between 2004 and 2014 (group B). The frontalis transfer procedures were modified conform to the following principles. The tip of the frontalis muscle flap included soft tissue that was as thick as possible and the soft tissue on the tarsal plate was removed to the greatest extent possible. A double fold was created in cases of unilateral ptosis. In order to evaluate the objective effects of modification, preoperative and postoperative values of the marginal distance reflex 1 (MRD1), the corneal exposure area, and the decrease in eyebrow height were compared between the two groups. Results In group A, patients showed an improvement of 1.19 mm in the MRD1, a 6.31% improvement in the corneal exposure area, and a 7.82 mm decrease in eyebrow height. In group B, patients showed an improvement of 2.17 mm in the MRD1, an 8.39% improvement in the corneal exposure area, and an 11.54 mm decrease in eyebrow height. The improvements in group B were significantly greater than those in group A. Conclusions Modified frontalis transfer showed better results than the conventional procedure and provided satisfactory outcomes.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.1
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• pp.92-102
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• 2009

Purpose: Relocation stress is a common phenomenon in patients discharged from an intensive care unit(ICU) to a ward. Therefore, nurses need to be aware of the problems that can arise during the transfer process. The aim of this study was to identify nurses' experiences in transferring critically ill patients from the ICU to a ward. Method: Focus group interviews were done with 13 nurses from wards and ICU, which participated in receiving and sending of ICU patients. The debriefing notes and field notes were analyzed using the consistent comparative data analysis method. Result: Seven major categories were identified in the analysis of the data. These were 'mixed feeling about transfer', 'lack of transfer readiness', 'increase in family burden', 'uncertainty with unfamiliar environment', 'difficulty in decision making', 'difference of perception of the relationships between patients and health care providers', 'need for continuity of nursing care'. Conclusion: Transferring out of the critical care area should be presented to the patient and family as a positive step in the recovery process. However, a more universal method of passing information from nurse to nurse is needed to assist in a smooth transition.