• Title/Summary/Keyword: 병원 의학

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Factors for Completing Case Management of Suicide Attempters: A Coihort Follow-Up Study Based on Data From Case Management of Emergency Room-Based Suicide Attempters (자살시도 환자의 지속적 관리 완수 요인: 응급실 기반 자살시도자 사후관리 사업 자료를 기반으로 한 코호트 추적 연구)

  • Ryou, Jae Hyun;Heo, Yoon Kyung;Kim, Da Seul;Kim, Sun Mi;Han, Doug Hyun;Min, Kyoung Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.176-183
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    • 2021
  • Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.

Postoperative Imaging Findings of Biliary Atresia (담도폐쇄증의 수술 후 영상 소견)

  • Jisun Hwang;Hee Mang Yoon;Pyeong Hwa Kim;Jung-Man Namgoong;Seak Hee Oh;Ah Young Jung;Jin Seong Lee;Young Ah Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1014-1031
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    • 2022
  • The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

Acute Hydrogen Cyanide Poisoning in a Plating Worker and Workplace Measurement (도금 사업장 근로자에게 발생한 시안화수소 급성중독과 작업환경평가)

  • Ham, Seunghon;Choi, Won-Jun;Lee, Junhyung;Lim, Yong su;Kang, Jihyun;Kang, Seong-Kyu
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.3
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    • pp.336-342
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    • 2019
  • Introduction: An unexpected death was reported in a beginner immediately after starting the work at a plating factory. After the incident, air sampling was performed using a simulation of the situation as it had been at the time. Methods: To evaluate the airborne concentration of hydrogen cyanide, a total of six samples were collected: one personal sample, three area samples, and two background samples (office and outdoors). Hydrogen cyanide measurement was performed according to the standard sampling protocol recommended by the U.S. NIOSH (National Institute of Occupational Safety and Health). Results: The highest concentration of hydrogen cyanide was 0.938 ppm measured in a sample collected from the plating bath area with local exhaust ventilation. This value was approximately 20% of the ceiling occupational exposure limit. The personal sample showed a concentration of 0.135 ppm. Samples collected near the bath in which the incident occurred and a dehydrator showed hydrogen cyanide concentrations of 0.236 ppm and 0.101 ppm, respectively. Hydrogen cyanide was not detected in the background samples (office and outdoors). Conclusions: It is necessary to use proper ventilation systems and respirators in plating factories to prevent acute poisoning. Furthermore, it is important to educate and train new workers dealing with toxic substances.

Psychosocial Factor Influencing Suicidal thoughts in Community Dwelling Elderly in Jeonnam Province (지역사회 노인의 자살사고에 영향을 미치는 심리사회적 요인 : 전남지역을 대상으로)

  • Cha, Yong-Ho;Kim, Kyung-Min;Yoon, Bo-Hyun;Kang, Hangoeunbi;Sea, Young-Hwa;Park, Su Hee
    • Mood & Emotion
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    • v.16 no.3
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    • pp.152-157
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    • 2018
  • Objectives : The purpose of this study was to examine psychosocial factors influencing suicidal ideation of community dwelling elderly, using the senior community center in Jeonnam Province. Methods : A total of 2,202 subjects (369 males, 1,833 females) were recruited. We evaluated sociodemographic factors, using a self-reporting questionnaire. Subjects completed the Geriatric Depression Scale-Short Form Korean Version (SGDS), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean version of the General Health Questionale-12 (GHQ-12) and Satisfaction with Life scale (SWLS), to assess psychosocial factors affecting suicidal ideation. Results : Among 2,202 subjects, 179 (8.1%) reported recent suicidal ideation. Self-perceptive health status (p<0.001) and physical disease (p=0.002) revealed differences between two groups. The scores of four scales in the suicidal group were significantly different from the control group: SGDS (p<0.001) and GHQ-12 (p<0.001) were higher, while MSPSS (p<0.001) and SWLS (p<0.001) were lower, in the suicidal ideation group than the control group. Multivariate logistic regression analysis revealed that physical disease (OR 2.575, 95%CI 1.022-6.492), SGDS (OR 1.181, 95%CI 1.120-1.246) and GHQ-12 (OR 1.192, 95%CI 1.108-1.283), were significantly associated with suicidal ideation. Conclusion : Findings support that physical disease, depression, and general mental health may correlate to suicidal ideation in the elderly.

A Review of Bee Venom Acupuncture for Spinal Diseases in the Journal of Korean Medicine (국내 임상연구 문헌고찰을 통한 척추 질환의 봉약침요법 응용례 분석)

  • Lee, Yujin;Won, Jee-Yeong;Nam, Suhyun;Kim, Changwan;Jeon, Gyeong-Ryung;Cho, Junho
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.1-13
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    • 2019
  • Objectives This review aims to analyze the current research trend in the usage of bee venom (BV) acupuncture for spinal diseases. Methods We collected 80 articles on BV acupuncture clinical study for spinal diseases by searching Korean web databases 'Journal of Korean Medicine Rehabilitation', 'Oriental Medicine Advanced Searching Integrated System', 'Korean Traditional Knowledge Portal' from 1999 to 2018. Results We summarized the most frequent clinical treatment methods of BV acupuncture. 1. Herniated intervertebral disc was treated for 40% and the treated spinal diseases were various. 2. '1:10,000' in the type of BV was chosen for 21%. 3. 29% of studies used 6-7 acupoints per session and 23% of studies used 'BL' as the injection site. 3. The highest volume of injected BV into each acupoint was 0.1 cc for 34% and the highest total volume of injected BV was 1.0 cc for 39%. Conclusions We found the limited evidence on the lack of consensus and detailed description in the reported experimental design. The results in this review suggest that future works should focus on more consistent and systematic study for the reproducible and standardized treatment methods.

A Qualitative Research on the Treatment Experiences of Patients with Serious Injury in Traffic Accidents Treated with Traditional Korean Medicine (교통사고 중상자의 한방치료 경험에 대한 질적 연구)

  • Kim, Seon Hye;Jo, Hyo Rim;Bong, Sung Min;Sung, Won Suk;Cho, Hyun Seok;Kim, Eun Jung
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.72-88
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    • 2019
  • Objectives: The purpose of this study is to understand the experience of traffic accident patients with serious injury treated with Traditional Korean Medicine (TKM). Methods: This study was conducted on the basis of grounded theory. We recruited 10 participants who had been hospitalized in Dongguk University Bundang Oriental Hospital after traffic accident. Raw data was collected by in-depth interview, and analyzed by using constant comparison. The coding(open-axial-selective) was performed in order to create paradigm and theoretical model, which can explain main theme of this study. Results: Core phenomenon of this study was 'Experiencing TKM treatment as an alternative' and core category was 'Searching for the answer to the management of traffic accident sequela through TKM treatment' Conclusions: For patients with serious injury, 'Experiencing TKM treatment as an alternative' has meaning as the following: First, The absence of accurate radiography and surgical management makes it hard for patients to choose Korean medicine hospital immediately after traffic accident. Second, Effectiveness of TKM treatment should be evaluated in the long term. Third, TKM treatment is superior to Western medicine treatment in managing long-term patients who suffered from serious injury involved in traffic accident. Finally, Cooperative service of the Western medicine and TKM will provide more satisfactory medical care for traffic accident patients.

The Electroconvulsive Therapy in the Prevention of Suicide Risks and Attempts (자살 위험성 및 자살 시도 방지에 대한 전기경련치료의 역할)

  • Kim, Hee Cheol;Jeong, Seong Hoon;Ahn, Yong Min;Park, Seung Hyun;Kim, Yong Sik;Chung, In Won
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.64-73
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    • 2020
  • Suicidality is the most serious complication of mood disorders and psychosis; effective treatment should reduce suicide rates. The Organization for Economic Cooperation and Development age-standardized suicide rate in Korea was 22.6 in 2018, much higher compared to other countries worldwide. As mental and psychiatric problems are the main reasons for suicide attempts, accounting for 31.6% in 2018, targeting such problems should be the focus of efforts to reduce suicide rates. However, the ability of current pharmacotherapeutic and psychotherapeutic interventions to reduce suicide rates is limited due to their delayed effects. Therefore, electroconvulsive therapy (ECT) has been proposed as an alternative treatment. This approach is effective for treating most mental disorders associated with high suicide rates, including severe depression, bipolar disorder, and intractable psychotic disorders; ECT is also effective for Parkinson's disease, which has the highest suicide rate among all disorders in Korea. The acute, long-term, and prophylactic effects of ECT on suicidality have been reported in the literature, and treatment guidelines outside of Korea recommend that ECT be used at an early stage for rapid reduction of suicide rates, as opposed to being applied as a treatment of last resort. However, only ~0.092 of every 10000 members of the Korean general population received ECT in 2018; this is much lower than the average rate worldwide, of 2.2 per 10000. Elimination of obstacles to the use of ECT, early crisis intervention involving administration of ECT for rapid stabilization, and maintenance ECT to prevent recurrence should reduce suicide rates.