• Korean Journal of Psychosomatic Medicine
• /
• v.29 no.2
• /
• pp.128-135
• /
• 2021

Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘²=14.397, p<0.001; 𝛘²=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.23 no.1
• /
• pp.73-84
• /
• 2022

■Objective The purpose of this case report is to report the effect of Korean medicine treatment on a patient with pontine infarction complaining of discomfort due to aggravated voiding dysfunction after the onset of the stroke. ■Methods The patient was hospitalized for 44 days and treated with herbal medicine, acupuncture, electroacupuncture, moxibustion, and interferential current therapy(ICT). We checked the amount of self-voided volume and postvoid residual urine volume(PVR), and asked the patient to subjectively evaluate the degree of discomfort due to voiding dysfunction. ■Results After 44 days of hospitalization, the patient responded that the subjective discomfort due to residual urine remained 30% and delayed urine remained 50% compared to the day of admission. The maximum amount of PVR was 234 ml on the 3^rd day, and the minimum amount of PVR was checked on 25^th and 35^th day as 0 ml. ■Conclusions This study suggests that Korean medicine treatment may be effective in the treatment of voiding dysfunction after stroke.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.346-351
• /
• 2022

Background Postmastectomy breast reconstruction (PMR) increases patient satisfaction, quality of life, and psychosocial well-being. There is scarce data regarding the safety of PMR in chronic anticoagulated patients. Perioperative complications can reduce patient satisfaction; therefore, it is important to elucidate the safety of PMR in these patients. Methods A retrospective case-control study of patients who underwent PMR with implants and were on chronic anticoagulation was performed at our institution. Inclusion criteria were women ≥ 18 years old. Exclusion criteria included autologous reconstructions, lumpectomy, and oncoplastic procedures. Two controls for every one patient on anticoagulation were matched by age, body mass index, radiotherapy, smoking history, type of reconstruction, time of reconstruction, and laterality. Results From 2009 to 2020, 37 breasts (20 patients) underwent PMR with implant-based reconstruction and were on chronic anticoagulation. A total of 74 breasts (40 patients) who had similar demographic characteristics to the cases were defined as the control group. Mean age for the case group was 53.6 years (standard deviation [SD] = 16.1), mean body mass index was 28.6 kg/m² (SD = 5.1), and 2.7% of breasts had radiotherapy before reconstruction and 5.4% after reconstruction. Nine patients were on long-term warfarin, six on apixaban, three on rivaroxaban, one on low-molecular-weight heparin, and one on dabigatran. The indications for anticoagulation were prior thromboembolic events in 50%. Anticoagulated patients had a higher risk of capsular contracture (10.8% vs. 0%, p = 0.005). There were no differences regarding incidence of hematoma (2.7% vs. 1.4%, p = 0.63), thromboembolism (5% vs. 0%, p = 0.16), reconstructive-related complications, or length of hospitalization (1.6 days [SD = 24.2] vs. 1.4 days [SD = 24.2], p = 0.85). Conclusion Postmastectomy implant-based breast reconstruction can be safely performed in patients on chronic anticoagulation with appropriate perioperative management of anticoagulation. This information can be useful for preoperative counseling on these patients.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.36 no.4
• /
• pp.138-142
• /
• 2022

This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.

• The Journal of the Korea Contents Association
• /
• v.22 no.2
• /
• pp.794-802
• /
• 2022

This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.35 no.1
• /
• pp.91-104
• /
• 2022

Objectives : The objective of this study is to report a case of a male atopic dermatitis patient accompanying seborrheic capitis and nummular eczema improved by Korean medicine therapy and lifestyle modification. Methods : A male patient was hospitalized for eczematous lesions in the head, face, and both hands which relapsed on March 2021. For 15 days, he took Korean medicine therapy including acupuncture, Bangpungtongseongsan-gagam, pharmacopuncture, and wet dressing with Hwangryunhaedok-tang. Simultaneously, lifestyle correction also conducted during administration. On the other hand, corticosteroid and antihistamine were prescribed from internal medicine of our hospital for the first 10 days because of severe skin lesions. As an outpatient, he was continuously treated by the same Korean medicine therapy except herbal decoction weekly for about 7 months after discharge. To assess symptoms, scoring atopic dermatitis(SCORAD) index, taking photos, and numerical rating scale(NRS) were used. Results : After 15 days of hospitalization, the SCORAD index decreased to 30.0, which was about a half of the initial SCORAD index(61.2). NRS score also dropped from 6 to 3. Despite stopping western medicine administration, skin lesions and subjective symptoms of the patient were steadily improved without aggravation. For 7 months of continued outpatient treatment, atopic dermatitis were steadily ameliorated despite temporary aggravation and improvement of symptoms, and seborrheic capitis was not relapsed. The final SCORAD index and NRS on November 9th, 2021 were 24.7 and 1, respectively. Conclusions : These results suggests that Korean medicine therapy contributes to improving SCORAD index, subjective symptoms, and skin lesions of the patient. Furthermore, lifestyle modification is also important as much as proper treatment for caring atopic dermatitis patients.

• Journal of Nutrition and Health
• /
• v.55 no.5
• /
• pp.572-586
• /
• 2022

Purpose: This study examined the factors that may affect the growth status of preterm infants. Methods: This study included 91 preterm infants born at <37 weeks of gestation (22.9-36.9 weeks of gestation), including 48 (52.7%) males and 43 (47.3%) females. Diet-related data were collected through parental questionnaires, and growth-related data, such as height and weight, were collected through the hospital medical records. Results: No significant difference in weight and growth was observed between early and late preterm infants. On the other hand, smaller averages of all weight z-score (recent weight at 40 weeks of gestation) included lower birth weight, height, and head circumference. On the other hand, infants' birth weight, height, and head circumference in the weight z-score of <0 (<50% in the age-weight growth chart) was smaller than those in the weight z-score of ≥0. Furthermore, neonatal intensive care unit (NICU) hospitalization period and NICU discharge were shorter with growth cessation age in weight z-score of <0. The weight growth velocity was associated with gestational age, birth weight, and medical treatment in the NICU. Thus, parents of preterm infants with low growth rates prefer more community care services for their children. Conclusion: Birth weight, age of preterm infants, and medical treatment in the NICU were factors related to early birth weight growth. Following NICU discharge, poor intake and intake issues were associated with poor growth after 40 weeks of gestation. Therefore, monitoring the growth of preterm infants requires continuous active involvement and supports for growth-promoting factors after NICU discharge.

• Korean Journal of Clinical Laboratory Science
• /
• v.54 no.4
• /
• pp.293-297
• /
• 2022

In 2022, Korea reported a total of 224 perfusionists, employing nurses or clinical laboratory technologists (also known as medical technologists) to provide hospital self-education or reliable education. In 2021, the total number of perfusionists in Japan was 2,100, mainly supported by clinical engineering technologists. During the same period, the number of perfusionists reported in the United States was 4,212, who had received training in the master's program, post-bachelor certificate program, and bachelor's program. Most personnel in the USA were graduates of healthcare sciences or life sciences. Perfusionists must be knowledgeable in heart anatomy, physiology, pharmacology, pathology, hemodynamics, laboratory analysis, and quality assurance, as well as techniques to operate the cardiopulmonary bypass machine (heart-lung bypass machine). These are jobs similarly handled by clinical laboratory technologists. The importance of perfusionists became more prominent during two major crises: the MERS-CoV and COVID-19 pandemic. Currently, perfusionists play a significant role in the rapidly expanding field of extracorporeal membrane oxygenation (ECMO) and extracorporeal circulation during cardiac surgery. Results of the current study indicate that hospitals offering cardiac surgery and infectious disease hospitalization need to be institutionalized to secure a certain number of qualified perfusionists. In the future, we look forward to establishing a perfusion technology association under the Korean Society for Clinical Laboratory Physiology to provide academic exchanges.

• Journal of the Korea Society for Simulation
• /
• v.18 no.3
• /
• pp.35-45
• /
• 2009

Emergency medical center(EMC) is the place for patients who need medical treatment immediately due to a disease, childbirth, or all sorts of accidents. Currently, most of EMCs use temporary beds because regular EMC beds cannot afford to serve all incoming patients. However, since it decreases the quality of service(QoS) of EMC patients and their guardians and efficiency of the EMC, some improvements are highly required to diminish the usage of temporary beds. The system duration time is one of the typical QoSs. This thesis proposes the information which is critical to make a better decision for cut down the number of temporary beds without sacrificing QoS of patients. The key point is to control the duration time of medical treatments for the consultation and hospitalization process, since it is the major reason of overcrowding in EMC and the usage of temporary beds. In this paper, we proposed an Arena simulation model reflecting real world substantially. Arena is one of the most widely accepted simulation softwares in the world. Using the developed model, we can obtain the optimal EMC operation parameters through simulation experiments. Optquest, included in the Arena, is used to make the developed simulation model collaborate with an optimization model. The results showed one can determine the set of optimal operation parameters decreasing the required number of temporary beds without deteriorating EMC patient's QoS.

• The Korean Society of Law and Medicine
• /
• v.24 no.2
• /
• pp.79-117
• /
• 2023

Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.