• Journal of Acupuncture Research
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• v.35 no.3
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• pp.129-137
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• 2018

Background: The purpose of this study was to determine the effect of Postural Yinyang correction of the temporomandibular joint (functional cerebrospinal therapy) on temporomandibular disorder. Methods: Medical records of 21 outpatients were reviewed who were diagnosed with temporomandibular joint disorder, unspecified (K0769) and treated at the Department of Acupuncture & Moxibustion, Dong-Eui University Korean Medicine Hospital from May $1^{st}$, 2017 to April $30^{th}$, 2018. Patients received more than 10 treatments of upper cervical manipulation and performed self-exercise therapy more than 3 times a day and wore an accurate balancing appliance in the oral cavity for more than 8 hours per day. To estimate the efficacy, visual analogue scale (VAS), numerical rating scale (NRS), maximum mouth opening (MMO), symptom intensity scale (SIS), max SIS (MSIS), symptom frequency scale (SFS), mandibular function impairment questionnaire (MFIQ) and 5-point Likert scale were used. Results: NRS and MSIS were significantly improved during each period. VAS, MMO, SIS, and SFS were significantly improved during each period, except the period from the $8^{th}$ to $10^{th}$ visit. MFIQ score was significantly improved during the period from the $1^{st}$ to $10^{th}$ visit. In the 5-point Likert scale, the results showed a high patient satisfaction with the treatment. Conclusion: These results showed that functional cerebrospinal therapy using an accurate balancing appliance, may be useful for reducing the symptoms of temporomandibular disorder.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.111-121
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• 2017

Purpose: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. Methods: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. Results: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. Conclusion: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.13-18
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• 2011

Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.25-30
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• 2010

Purpose: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. Materials and Methods: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5$^{th}$ intermetatarsal angle (4-5$^{th}$ IMA), the 5$^{th}$ metatarsophalangeal angle (5$^{th}$ MPA) and the length of 5th metatarsal bone (5$^{th}$ MTL) were analyzed at preoperatively and at final follow up visit. Results: VAS improved from $6.8{\pm}1.8$ points to $2.2{\pm}1.8$ points (p<0.05). AOFAS score improved from $54.0{\pm}14.2$ points to $90.0{\pm}4.8$ points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5$^{th}$ IMA was corrected from $10.1{\pm}2.3^{\circ}$ to $4.4{\pm}1.7^{\circ}$ (p<0.05). The average 5$^{th}$ MPA was corrected from $11.5{\pm}8.6^{\circ}$ to $-0.1{\pm}4.1^{\circ}$ (p<0.05). The average 5$^{th}$ MTL was changed from $66.1{\pm}4.3$ millimeters to $64.1{\pm}4.4$ millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. Conclusion: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.126-130
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• 2016

Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.1
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• pp.33-40
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• 2016

Objectives Despite the increasing use of Ja-ha-guh (Hominis-placenta ) pharmacopuncture in rehabilitative medicine field, its standard compound has yet to be investigated. The purpose of this study is to provide standardization for future studies and increase satisfaction of patients by utilizing standard pharmacopuncture. Methods Alanine and leucine were selected as potential standard compounds. LC/MS was used to devise an analytic method. This analytic method was subject to validation. According to validation guideline of Korea Food and Drug Administration, the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy were measured. With this analysis, 3 lots of Ja-ha-guh pharmacopuncture were analyzed. Results Because the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy meet criteria of the guideline, the analytic method was validated. It was found that Ja-ha-guh pharmacopuncture contained $211.02{\pm}7.28ug/ml$ of alanine and $372.03{\pm}7.58ug/ml$ of leucine. Conclusions Both alanine and leucine appear to be suitable standard compounds. These results are likely to contribute to further standardization of Ja-ha-guh for medical use.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.337-352
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• 2003

Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

• Journal of Rhinology
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• v.25 no.2
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• pp.86-90
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• 2018

Background and Objectives: Although polyvinyl acetate ($Merocel^{(R)}$) has been widely used as a packing material after septoplasty, removable nasal packing can increase patient discomfort, local pain, and pressure. Furthermore, the removal of nasal packing has been described as the most uncomfortable and distressing feature associated with septoplasty. The purpose of this study was to investigate the efficacy of polyvinyl acetate with carboxymethyl cellulose sheet ($Rhinocel^{(R)}$) nasal packing on patient subjective symptoms, degree of bleeding, hemostasis, and wound healing following septoplasty. Subjects and Method: Forty patients with nasal septum deviation requiring septoplasty were included. Following surgery, one nasal cavity was packed with $Rhinocel^{(R)}$ and the other one with $Merocel^{(R)}$. Patient subjective symptoms while the packing was in situ, hemostatic properties, pain on removal, degree of bleeding on removal, duration of hemostasis after removal, postoperative wound healing, and the cost of the pack were evaluated. Results: Although the two types of packing materials were equally effective in controlling postoperative bleeding after septoplasty, $Rhinocel^{(R)}$ was significantly more comfortable while in situ and less painful on removal than $Merocel^{(R)}$, which was associated with significantly more bleeding on removal and so more time was needed to control hemorrhage. There was no significant difference in postoperative wound healing or pack cost. Conclusion: The use of $Rhinocel^{(R)}$ after septoplasty has less discomfort, greater patient satisfaction, and less bleeding on removal with no adverse reactions compared to $Merocel^{(R)}$ packing. Therefore, $Rhinocel^{(R)}$ may be a useful packing material after septoplasty.

• Korea Science and Art Forum
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• v.19
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• pp.417-424
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• 2015

The healthcare service industry has become one of the business industries in South Korea where service design is most actively being researched on and applied. In accordance with the recent upsurge of the interest in health, healthcare service is expanding its area including disease prevention, patient management, and rehabilitation treatment as well as cure and nursing care. The health manpower is the supplier, and their professional knowledge and ability and the patients' trust in medical technology are the most important factors for their customers. In addition, service design has come into the spotlight given that the medical institute system, health manpower attitude, and information delivery system and touch point are considered important factors contributing to customer satisfaction. It is very hard to satisfy customers only through professionalism, the environment, and product improvement because healthcare service deals with much more sensitive and emotional customers compared to other service industries. This means that a change in the service mind-set and the attitude of the health manpower as emotional labourers have practical effects. Therefore, the fundamental solution is to establish a system that provides related education with manpower and that settles various problems by itself. This paper introduces several solutions, such as education for health manpower and a service design system applied to a national-university-affiliated hospital in South Korea, and takes a close look at its effects.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.110-122
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• 2009

Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.