• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.6495-6503
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• 2015

The purpose of the study was to evaluate patients' compliance with the hemodialysis and to investigate relationships between compliance, physiological parameters, and health-related quality of life. Data were collected from 220 patients at 27 local hemodialysis clinics. Compliance was measured with Sick-role Behavioral Compliance including interdialytic weight gain, serum potassium, and phosphorus. Health-related quality of life was assessed using Medical Outcomes Study Short Form-12. Data were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation. Total compliance scored 2.92 out of 4 points on average. Among fifteen items, 'I keep on my dialysis schedule(time and date)' was the highest score. There were differences in the scores for compliance according to age, marital status, and dialysis period. Statistically significant correlations were found between four compliance items(medication, infection control, sleep, eating vegetable and fruit) and health-related quality of life. The results of the study indicate that a patient-centered approach would be helpful to improve quality of life in patients with hemodialysis. Healthcare providers need to understand the patients' perspectives by identifying what is important to patients and taking patient values and priorities into account.

• The Journal of Korean Medicine
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• v.34 no.4
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• pp.56-62
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• 2013

Objectives: Hepatocellular carcinoma patients have a poor prognosis and survival beyond 5 years is very rare in spite of western treatment. We report a case of long-term survival of a hepatocellular carcinoma patient treated by Korean medicine combined with western therapy. Methods: The treatment was provided from November 2004 to July 2012. Herbal medicine, acupuncture and moxibustion treatment were used as main treatment methods. We prescribed herbal medicines three times a day and performed acupuncture and moxibustion an average of 2-3 times a week. Clinical laboratory tests were performed each month and a CT scan was carried out 13 times during the treatment period. In order to evaluate the disease status, we checked the patient's abdominal circumference, weight change and subjective symptoms regularly. Results: During treatment, subjective symptoms of the patient and state of ascites due to hepatocellular carcinoma were relatively stable. The progress of hepatocellular carcinoma was gradual without worsening rapidly. Since the initial diagnosis with hepatocellular carcinoma, the patient survived for a further 7 years and 9 months treated by Korean medicine combined with western treatment. Conclusions: According to the above results, this case indicates that Korean medical treatment combined with western therapy for hepatocellular carcinoma patients has synergistic effects of prolonged survival, relief of symptoms and management of complications.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.29-34
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• 1999

Objectives: This study was carried out to analyze the clinical profile and the results of treatment of a series of patients with extramedullary plasmacytoma(EMP) of the head and neck. Materials and Methods: The clinical features, treatment and survival of 14 patients with EMP seen at Yonsei Medical Center between 1970 and 1998 were carefully reviewed. Results: The median age was 48 years(range 15-75) and there was a male predominance(M:F 1.8:1). Nasal cavities and paranasal sinuses account for 50% of the primary sites and the most common symptom was airway obstruction(50%). Five patients(36%) showed evidence of adjacent bone destruction, one patient had lymph node involvement and one patient had an IgG monoclonal gammopathy at the time of diagnosis. All 5 patients treated with radiotherapy alone achieved local control. Of 5 patients treated with surgery alone, 2 patients(40%) had local failure. Of 3 patient treated with a combination of surgery and radiotherapy, one patient had local recurrence. A total of7 patients(54%) had local, distant or nodal relapses after primary treatment. Six of them received salvage treatment. With salvage treatment of surgery and/or radiotherapy, local control was achieved in 4 of 6 patients. Conversion to multiple myeloma was seen in one patient. Conclusion: Radiotherapy should be recommanded as treatment of choice for EMP of the head and neck. Surgery should be reserved for radioresistant or recurrent tumors, but tumors that are localized and can be removed relatively easily with little morbidity may be treated by primary surgery.

• Korean Journal of Veterinary Service
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• v.34 no.2
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• pp.191-193
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• 2011

A 3-month-old intact male, Labrador retriever was presented with the history of coagulopathy and anemia. The results of initial screening tests of the hemostatic system yielded a tentative diagnosis of hemophilia. Activated partial thromboplastin time (APTT) was distinctly prolonged (106 seconds) and prothrombin time (PT) was not detected due to markedly prolonged test time. Whole blood transfusions (20 me l/kg body weight) were carried out prior to assays of coagulation factor. After transfusion, the patient recovered well and hemorrhage ceased. Blood samples were assessed for coagulation factor activity. The patient showed markedly low factor IX coagulation activity (5%, reference range: 7~140%) and was diagnosed with hemophilia B. After recovery, the patient was discharged from the hospital. However, 4 months later the patient was re-hospitalized for recurrence of the initial symptoms. The owner did not want to pursue further treatment and the patient died of respiratory distress two days later.

• The Journal of Korean Medicine
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• v.30 no.1
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• pp.40-50
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• 2009

Objectives: The clinical document forms, a format for collecting clinical data, is the most fundamental object of standardization. Doctors must have a mutual understanding of the clinical chart. Methods: Clinical document forms were developed by investigating existing conditions in hospitals and conducting demand surveys, doing literature research, and seeking expert advice for the improvement of version 1.0. In addition, an organization of a network of 19 Oriental medical doctors and nurses, 190 patients, and users of collected and assessed data was formed to come up with version 2.0. Results: The overall format was divided into different portions that the patient, nurse, and doctor must fill out, respectively. The patient's section consists of demographic data, lifestyle details, history, and symptoms. The data to be supplied by the nurse include the patient's vital signs and anthropometric parameters. As for the doctors, they are to supply data regarding the patient's palpitation, the detailed symptoms of the patient's head, ophthalmological and otorhinolaryngological symptoms (mouth), respiration, circulatory organ and chest conditions, digestive-organ conditions (thirst), neuropsychiatric conditions, reproductive system, musculoskeletal system, skin (depilation), etc. Conclusions: Common clinical chart development is the prior question to Traditional Korean Medicine standardization. A web-based clinical document format should be developed to support diagnosis and treatment, and furthermore EMR (electronic medical record system) and EHR (electronic health record) developed. Clinical information could be shared through a network of medical institutions and be useful Traditional Korean Medicine for evidence-based medicine.

• YAKHAK HOEJI
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• v.49 no.6
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• pp.449-458
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• 2005

There have been rapid changes in the pharmaceutical environment after the separation of Dispensing and Prescribing practice. In the early stage of this system, outpatients had few options to choose their pharmacies due to various obstacles. Under these circumstances, this study on the defection tendency of long-term care patients was performed through the analysis of outpatients who quit visiting a pharmacy nearby general hospital. PowerBuilder ver 9.0 program was used to extract significant data, and SPSS package was employed for statistic analysis. 3,308 outpatients who visited a pharmacy nearby hospital for a month (in January, 2004) were studied. Patients' sex, age and location of residence, the class of medical insurance, the characteristic type of medication (powder, split form, medication for external use/injection), waiting time, disease (department) were considered as variable factors. It turned out that the patient revisit ratio was 80.8$\%$ and the patient defection ratio was 32.4$\%$. As was expected, those factors mentioned above influenced on the revisit and defection ratio considerably. In terms of patient factors, it proved that there was no relationship among sex, location of residence, the class of medical insurance and revisit (defection) ratio. Only age factor influenced the ratio; the older, the higher revisit ratio and the less defection ratio. In respect of dispensing factors, there were obvious relationships among the factors and the ratio: bill (money they had to pay individually), waiting time, number of medications, splitting of tablets, unit price of drug and revisit (defection) ratio showed significant relationship. The result of this study revealed an aspect of outpatients' behavior and it could be used as a reference for better patient service and customer relationship management.

• Journal of Acupuncture Research
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• v.31 no.3
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• pp.75-82
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• 2014

Objectives : The purpose of this study is to investigate the effects of warm needling therapy in a patient with cervical myelopathy caused by ossification of posterior longitudinal ligament. Methods : A 53-year-old Korean male patient diagnosed with cervical myelopathy due to ossification of posterior longitudinal ligament was treated with warm needling therapy on posterior neck aside from the routine inpatient treatment from June 26th to July 16th. Clinical improvement was evaluated with visual analogue scale(VAS), Japanese orthopedic score(JOA), grip and release test, finger escape sign and patient satisfaction was measured using a five-point Likert scale. Results : After 21 days of treatment, the patient showed improvement in VAS, JOA, grip and release test and finger escape sign. The patient also expressed satisfaction with the treatment. Conclusions : The results suggest that warm needling therapy may be an effective additional treatment for cervical myelopathy and other symptoms related to ossification of posterior longitudinal ligament(OPLL). Further studies should be carried out regarding possible long-lasting effects.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.207-212
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• 2012

Purpose: This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college. Materials and Methods: This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'. Results: Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable. Conclusion: The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.89-100
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• 2018

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.37-54
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• 2017

Objectives: The purpose of this preliminary study was to identify the nurses' perception regarding disclosure of patient safety incidents (DPSI) and to evaluate the effectiveness of education for DPSI. Methods: DPSI education was conducted for nurses majoring in clinical nurse specialist at an university. Before and after the education, the nurses made a questionnaire to evaluate the perception of DPSI. The questionnaires were divided into four categories: first, overall perception of the DPSI; second, recognition evaluation of the DPSI using hypothetical case, third, opinion on legal and nonlegal measures for facilitating the DPSI; and fourth, socio-demographic factors. The Wilcoxon signed rank test was performed on the DPSI questionnaire response to compare the perceptions before and after the education. Results: A total of 10 nurses participated in the education. DPSI education showed the possibility of improving the overall perception, necessity, effect, obstacle, and promotion method of DPSI, although there were also several responses where there was no statistical significance. In particular, DPSI education led to statistically significance change in the perception of obstacles for DPSI. For example, the number of respondents who agreed to the item "DPSI will increase the incidence of medical lawsuits." was 7 before education but decreased to 3 after education (P-value: .025) Furthermore, nurses' perception of DPSI from this study was generally positive regardless of education. Conclusion:In the future, it will be necessary to carry out DPSI education and training and to evaluate its effectiveness for more nurses.