In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.
Kim, Ji Tae;Nam, Young Mee;Lee, Jae Seung;Kim, Dong Soo
Clinical and Experimental Pediatrics
/
v.50
no.1
/
pp.74-78
/
2007
Purpose : Systemic lupus erythematosus (SLE) is a chronic multisystemic autoimmune disease with complex clinical manifestations. It probably involves genetic, environmental and immunologic factors. In this study, we investigated the clinical manifestations, laboratory findings and prognosis of pediatric SLE to aid clinical care of pediatric SLE. Methods : The data of 45 patients who were diagnosed as pediatric SLE in Severance Children's Hospital from Jan. 1996 to Dec. 2005 were analysed retrospectively. Results : The mean age at diagnosis was 10.8 (0-15) years old. And the ratio of male to female patients was 1:4. The initial manifestations were facial edema (51.1 percent), malar rash (44.4 percent), and fever (28.9 percent). The ANA (97.8 percent), anti-ds DNA antibody (82.2 percent), lupus nephritis (71.1 percent), malar rash (71.1 percent), and cytopenia (66.7 percent) were the most common findings among the classification criteria by ACR (American College of Rhematology, 1997). Conclusion : Clinical manifestations and prognosis are various in pediatric SLE. Intensive studies of SLE in children should be continued for more effective treatment.
This research was performed to develop seminal propagation method of Saururus chinensis (Lour.) Baill. by conducting a rigorous germination study. Well-selected seeds were dry-stored at 4 ± 1.0℃ during the experiment. To study dormancy type, non-stored seeds were analyzed by embryo observation, germination test and detecting for any difficulties in seed coat to absorb moisture. Then to improve germination, seeds were submerged for 24 hours in a solution of varying concentrations containing one of plant growth regulators and minerals. According to research, fleshly matured seeds had an undifferentiated embryo and had a low germination rate below 5%. In addition, water submersion led to moisture absorption, embryo in the seeds grew and germinated so it was deemed morphophysiological dormant seeds. Percent germination (PG) and germination energy (GE) was greatly improved by soaking in plant growth regulators and minerals for 24 hours. Especially, 500 ㎎/L GA3 treatment resulted in the highest GE as 46.1%. KNO3 meaningfully improved PG (54.3∼57.7%) at 10∼20 mM but effect of minerals on germination acceleration as GE were negatively impacted in all concentrations.
5.18 Gwangju Democratization Movement was approved as a legal democratization movement by president Kim Young Sam in May 1993 and was approved as a global recording inheritance by UNESCO in May 2011 for the honor of Gwangju citizens to be restored. However, assessment on this until today after 35 years of occurrence is not nationally unified and the mind of Gwangju maybe only remembered as pride by Gwangju. There are several factors of this continuing situation but this researcher thinks the biggest factor is that professionals reanalyzing the truth ascertainment fitting spirit of the times who are in charge of citizen education are intensively distributed in Jeolla-do and Seoul. Moreover, the journal unlikely assessing 5.18 have enemies in the assailant area during activity that unity is not taking place with divided assessments and trapped in Honam. This study judges that the reason the meaning of 5.18 is trapped in Honam and not nationally unified is because of the limit of "adversary system." Especially researchers who should analyze and explain this incident in a objective views are bias distributed (Gwangju Jeolla-do> Seoul>Gyeongnam) in hometown areas that the possibility of 5.18 meaning not being unified was focused. Academic research studies, journal writers, and publication locations are divided in this study to reveal they are bias distributed and reveal that there is possibility that this biased distribution of researches are becoming obstacles in overcoming regionality.
Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.
Background: Goal of the initial treatment of primary spontaneous pneumothorax is re-expansion of the lung by evacuation of air from pleural space. Authors thought small caliber catheter could reach to this goal instead of conventional large bore chest tube. This retrospective study was undertaken to assess the effectiveness of 7-French (Fr) catheter for the initial treatment of primary spontaneous pneumothorax. Material and Method: Between May 2003 and April 2005, 111 patients with primary spontaneous pneumothorax were managed with tube drainage; 7 Fr catheter for 86 patients and 24-French chest tube for 25 patients. We analyzed catheter indwelling time, use of analgesics, re-expansion of the lung, and catheter related problems by medical records. Result: Mean catheter indwelling time was $2.4{\pm}1.1$ days in 7 Fr group and $2.3{\pm}1.3$ days in chest tube group (p>0.05). All patients with 24 Fr catheter needed analgesics injection but never in 7Fr group. Complete re-expansion of the lung based on plane chest radiograph was obtained in 77% of 7 Fr group. The problem related with 7 Fr catheter was kinking, which showed in 5.6%. Conclusion: Application of the 7 Fr catheter for initial management of primary spontaneous pneumothorax was as effective as 24 Fr catheter.
Purpose : Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children. Methods : From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy. Result : Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures. Conclusion : In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it.
Purpose: Patients with hematologic diseases such as chronic myeloid leukemia (CML) or chronic lymphoid leukemia (CLL) are known to have an increased chance of acquiring a secondary neoplasm. Stomach cancer is one of the most common malignant diseases in Korea, and we investigated whether the incidence of secondary stomach cancer in patients with a hematologic disease increases, in order to determine if a more intensive screening program for detecting secondary gastric cancer was required. We also investigated the safety of performing a gastrectomy in hematologic disease patients. Materials and Methods: From 1992 to 2006, the medical records of 8376 patients diagnosed with one of the six common hematologic diseases were reviewed. Results: Nine secondary stomach cancers were found among the 8376 patients during the 15-year observation period. No surgical-related complications occurred, and there was no recurrence of stomach cancer if detected early. Conclusion: It seems that a more intensive screening program for detecting secondary gastric cancer in hematologic disease patients is not required, and surgery is not risky in these patients.
Purpose : Congenital urinary tract anomaly is the most common anomaly in the childhood and progress to chronic renal failure and growth retardation. Therefore, early diagnosis arid treatment of urinary tract anomaly are important. Method : We reviewed medical records of 124 patients who had urinary tract anomalies on radiologic studies from Jan. 1986 to Dec. 1996. We analyzed demography and clinical characteristics of urinary tract anomalies. Results : 1) The age distributions were as follows ; 61 cases of 124 patients (49%) were under 1 year, 11 cases (8.8%) from 1 to 3 years, 20 cases (16%) from 4 to 6 years, 10 cases (8%) from 7 to 9 years, 9 cases (7.2%) from 10 to 12 years, 10 cases (8%) from 13 to 15 years, and 3 cases (2.4%) from 16 to 18 years. 2) Chief complaints in patients with urinary tract anomalies were fever, flank pain, prenatally diagnosed hydronephrosis, abdominal mass, dysuria and hematuria. 3) Of 124 patients, 68 cases(54.8%) were combined with urinary tract infection, and main causative organism was E.coli, and the most frequently associated anomaly was vesicoureteral reflux. 4) Most of the urinary tract anomalies were VUR, UPJ obstruction, congenital hydronephrosis and double ureter in order of sequence. 5) Whereas the frequency of simple urinary tract anomaly was 87.9%, that of complex anomaly was 12%. 6) Operative corrections were needed in 47 cases and 7 cases were progressed to renal insufficiency. Conclusion : We emphasize that early detection of urinary tract anomaly, appropriate treatment and regular follow-up are needed.
The primary purpose of this study is to design and perform juvenile group program and. to evaluate the effectiveness of that program The group was consisted of 10 fourth-grade elementary school boys who have had such factors that might force themselves to be delinquent, for example, broken family, having delinquent siblings or friends, family violence, and etc. The group had been held once a week and continued for 5 months. The effectiveness of that program is evaluated quantitatively and qualitatively through goal-attainment model. The ultimate goal of this program is reduction of delinquency stimulating factors which are operationalized with overall self-esteem - family related self-esteem, friend related self-esteem, and school related self-esteem. Quantitative evaluation is performed by pre- and post-test with Hare Self-Esteem Scale. Case records, family records, group activities records, and reports from schools are analyzed for the qualitative evaluation. According to paired samples t-test scores, average overall self-esteem scores of experimental group members were escalated from 67.57 to 74.86, and this difference between pre-test and post-test was statistically significant. Difference of experimental group was bigger and more striking than that of control group. These results suggest that designed and performed group program in this study would be effective in preventing juvenile from being delinquent.
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