• Journal of Chest Surgery
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• v.48 no.1
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• pp.74-77
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• 2015

Chylothorax is a rare postoperative complication of a thoracic surgical procedure. Here, we report a case of chylothorax after thoracic endovascular aortic repair with debranching for the distal arch aneurysm of the aorta. First, the patient was treated by a medical method (nil per os, fat-free diet, and octreotide), but this method failed. The patient strongly refused surgical treatment. Therefore, we tried to occlude the thoracic duct by lymphangiography Lipiodol, and this line of treatment was successful.

• Journal of Nutrition and Health
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• v.26 no.4
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• pp.443-454
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• 1993

The purposes of this study were to analyze the work patterns of selected hospital foodservices by Work Sampling methodology, and to investigate the relationship among operational factors affecting productivity. The hospitals were classified into 3 groups by the percentage of patient meals, and the percentage of special patient diet, and the menu items of patients meals. The groups clustered were characterized by productivity. Work Sampling methodology was utilized to analyze the work patterns of hospitals with selected 3 hospitals to investigate the productivity the productivity and labor times used in each work functions. Productivity index analyzed by Work Sampling were 10.36 min/meal, 10.95 min/meal, and 12.19 min/meal, respectively X, Y, Z hospital. Z hospital was significantly different from time used in direct work function and delay. Direct work function time was the highest, delay the lowest in Z hospital. The relation between the results of Work Sampling and the productivities of 3 groups showed not by delay but direct work function in the classification used in this study.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.177-179
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• 2018

A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.

• Clinical Nutrition Research
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• v.12 no.1
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• pp.1-6
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• 2023

Gastrectomy is the most effective method of treating gastric cancer, but it is commonly associated with weight loss, nutritional deficiencies, and the increased risk of malnutrition due to post-surgery complications, including gastric stasis, dumping syndrome, malabsorption, and maldigestion. Malnutrition is a risk factor for postoperative complications and poor prognosis. To prevent it and guarantee a quick recovery after surgery, continuous and individualized nutrition intervention should be performed both before surgery and postoperatively. The Department of Dietetics at Samsung Medical Center (SMC) performed nutritional status assessment before gastrectomy, initial nutritional assessment within 24 hours of admission, description of therapeutic diet after surgery, nutrition counselling before discharge, and nutritional status assessment and individual nutrition counselling after 1, 3, 6, and 12 months from surgery. This is a case report of a patient who underwent gastrectomy as well as intensive nutrition intervention in SMC.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• Journal of Korean Medicine for Obesity Research
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• v.9 no.1
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• pp.79-86
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• 2009

Objectives The purpose of this study was to investigate the clinical effect of oriental obesity therapy on obese patient with non-alcoholic fatty liver disease(NAFLD). Methods The patient was treated from November 17, 2008 to May 15, 2009 for obesity treatment. And the patient had intensive care through admission treatment from November 17, 2008 to November 29, 2008. Electrolipolysis, auricular acupuncture, herbal medicine, low calorie diet and aerobic exercise were done during the treatment period. Results His body Weight decreased from 102.8kg to 82.7kg. The BMI decreased from 35.2kg/m$^2$ to 28.9kg/m$^2$. NAFLD effectively improved on sonography form grade II${\sim}$III to grade I${\sim}$II after oriental obesity therapy, AST decreased from 65 to 19. ALT decreased from 152 to 18. Oriental obesity therapy could be effective to treat obese patient with NAFLD. Conclusions The obese patient with NAFLD improved on sonography by oriental obesity therapy.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.129-138
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• 2009

purpose : The purpose of this paper is to report that the fasting treatment was quick and effective against the menopausal depression. So that the further study on the fasting treatment for the menopausal depression is expected. methods : This fasting treatment included three periods. The first was to reduce the food intake and the sodium intake as well. The second was for fasting for two weeks. During this period, the patient drank 250cc of the fermented herbal juice and 2500cc of water a day and had the lactobacillus supplement twice a day. Then, the third was for rebuilding. During the rebuilding period, the patient followed the limited sodium diet for two weeks. results : After the fasting treatment done, the symptoms that patient complained before went away. The BDI score went down from 19 to 3. And, of course, the patient lost her body weight and the fat. conclusions : The 49-year-old female patient in the menopause period was suffering from the lack of energy, depression, sleeping disorder, constipation, and weight gain. She took the fasting treatment along with the acupuncture at the holistic medical clinic, 'The Seasons' from Jan 16th 2009 to Feb 27th(the main fasting period was for 14 days). The BDI score indicated that she had the depression as her score was 19 at the first examination. After the treatment was completed, the BDI score dropped to 3. Therefore, I report the immediate effect of the fasting treatment again the depression. Women are twice as likely to get the depression as men. Especially, the women in menopause period tend to get the depression as they are facing the physical, mental, and social changes which can act as the stressors. Besides, women tend to get depressed when they gain weights. Thus, I suggest the further study on the fasting treatment should be carried on so to apply it more positively to various problems in the field of the psychiatry.

• Korean Journal of Community Nutrition
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• v.14 no.2
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• pp.236-244
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• 2009

Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy(4.00) was higher than those who had not practiced diet therapy(P<0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education(3.59) was higher than those who had no nutrition education(P<0.05) and subjects who had practiced diet therapy showed higher score(3.59) than those who had not practiced diet therapy(P<0.05). 'Exercise behaviors score' of subjects who were over 60(3.59) was the lowest(P<0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores(3.38) than those who had no nutrition education(P<0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores(3.72) than those who had not practiced diet therapy(P<0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores(3.78) concerning BMI(P<0.05). In conclusion, this study expected that Nutrition educators(Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.

• Journal of Korean Medicine for Obesity Research
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• v.8 no.1
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• pp.101-108
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• 2008

Objective The purpose of this study is to evaluate the effectiveness of obesity management program with herbal medication(Changbudodamtanggamibang) on an obese female patient with oligomenorrhea resulted from polycystic ovary syndrome. Methods I applied herbal medication(Changbudodamtanggamibang), acupuncture, auricular acupuncture, electrolipolysis, low calorie diet, aerobic exercise, behavioral modification therapy and fumigation therapy to her. Results Her weight decreased from 64.3kg to 54.0kg, BMI from $26.4kg/m^2$ to $22.2kg/m^2$, PBF from 38.9% to 29.6%, and WHR from 0.89 to 0.82. Menstrual period was normalized from 60days to 34days. ConclusionThese results provides an evidence that obesity management program with herbal medication(Changbudodamtanggamibang) is effective on oligomenorrhea of an obese female patient with polycystic ovary syndrome.