• Title/Summary/Keyword: 의료의 선택

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Change of Antimicrobial Use Density According to Application of Computerized Management Program for Restriction of Antimicrobials Use in a University Hospital (일개 대학병원에서 제한 항생제 전산 프로그램 운용에 따른 항생제 사용량 변화)

  • Lee, Bo Young;Kim, Chun Soo;Ryu, Seong Yeol;Kwon, Ki Yung;Lim, Jung Geun;Lim, Tae Jin;Min, Byung Woo;Ryoo, Nam Hee;Cha, Soon Do
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.155-162
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    • 2006
  • Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.

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Evaluation of Biocompatibility of Extracorporeal Circuit - Development of a Quantification Technique using in-vivo Injection of Tc99m Radioactive Platelets - (체외순환도관의 혈액적합성 평가 - 방사선 동위원소(Tc99m) 활성화 혈소판의 생체 내 주입을 이용한 정량분석법의 개발 -)

  • Lee, Sung-Ho;Sun, Kyung;Choi, Jai-Geol;Son, Ho-Sung;Jung, Jae-Seung;Ahn, Sang-Soo;Oh, Hye-Jung;Lee, Whan-Sung;Lee, Hye-Won;Kim, Kwang-Taik;Jeong, Yoon-Seop;Kim, Young-Ha;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.171-176
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    • 2002
  • Background: Blood-foreign interaction cause activation of coagulation and inflammatory process that may lead to multiorgan dysfunction and determine the surgical outcomes. Of the methods for assessing the biocompatibility, the platelet adhesion study is considered as the most valuable evaluation step in blood-foreign interaction. As the most studies have used in-vitro or ex-vivo conditions, we have developed a technique of quantification for platelet adhesion on the blood contact surface by using in-vivo injection of radioactive platelets. Material and Method: A coupled bypass circuit was designed to connect the proximal and descending thoracic aorta in 6 piglets(20∼25 Kg). One side of the circuit tube was consisted of a heparin coated PVC tube(10mm in ID, n=6, Experimental group), and the other, a non-heparin coated PVC tube(10mm in ID, n=6, Control group). After cannulation, the blood was circulated through the circuit for 2 hours. Platelet concentrate was prepared from homologous pig blood 24 hours before the experiment. The platelet concentrate was incubated with Tc-99m-HMPAO for 30 min and then centrifuged for 10 min. The supernatant was discarded and the radio-labeling efficacy was measured. The radio-labeled platelet concentrate was mixed with the autologous plasma to make the volume 5 ml, and the mixture was injected intravenously into the experimental animal. After 2 hour circulation, 5 pieces of the specimen(10mm in length each) were obtained from each PVC tube. The radioisotopes were counted with a gamma counter(Cobra ll, Packard, USA), and the ratio of radioisotope count was compared between the control and experimental group. Result: The radioisotope count number was 537.3221.1 Ci/min in the control group and 311.1 184.5 Ci/min in the experimental group(p=0.0104). The ratio between the groups was 1 to 0.58 (p=0.004). Conclusion: In vivo quantification using technetium-99m-HMPAO labeled platelets is simple and reproducible in evaluating platelet adhesion on a foreign surface. We suggest this technique to be a useful tool for blood compatibility test.

The Disclosure of Cancer Diagnosis and its Prognosis (암 환자 병명통고)

  • Park, Jean-No;Choi, So-Eun;Choi, Kyung-Mee;Hong, Young-Seon;Lee, Kyung-Shik;Yang, Soo
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.169-178
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    • 2004
  • Purpose: The aim of the study was to assess changes of the attitudes and opinions about disclosure of cancer diagnosis to patients. Methods: We analyzed the attitudes and opinions of in-patients with metastatic cancer, their families, physicians, nurses, medical students, nursing students. Three questionnaires were used for in-patients, families, and surroundings in hospital. Data was collected in the St. Mary hospital for 3 months from October, 2002. We investigated the preference of disclosure, the reason the patients should be informed of disclosure, when, how and who to tell the cancer diagnosis to patients. 242 persons participated in these questionnaires (50 in-patients, 50 their families, 51 physicians and nurses, 41 medical students, 50 nursing students). Only 34 in-patients with metastatic cancer were enrolled, and so 16 in-patients with lymphoma were added. All in-patients were undergoing anticancer chemotherapy. Results: 89.3% of the participants wanted to be told about disclosure of cancer and terminal illness (in-patients 98.0%, their families 88.0%, physicians and nurses 90.2%, medical students 73.2%, nursing students 94.0%, in-patients with metastatic cancer 97.1%). 79.8% of the respondents hoped that the moment to tell the truth was immediately when the disease was diagnosed (in-patients 94.0%, their families 80.0%, physicians and nurses 68.6%, medical students 68.3%, nursing students 86.0%). 64.4% of all prefered to be told the truth once for alt including patients' diagnosis, present status and prognosis (in-patients 81.6%, their families 66.0%, physicians and nurses 56.0%, medical students 48.8%, nursing students 70.0%). Most indicated the first reason to be told the truth was the possibility to participate in treatment design. 86.4% responded that physicians were the proper persons to disclose the diagnosis. Conclusion: Not only in-patients, families but also physicians, nurses, medical students and nursing students all preferred the disclosure of cancer diagnosis. This preference was increased compared with the previous papers. The first reason to be told the truth was the possibility to participate in treatment design. Most of the participants wanted to be told the truth once for all.

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Development of Loading Information System in Shin-Chon Region (하숙 정보 시스템 구축:신촌지역을 중심으로)

  • 이숙임;성효현;강애띠
    • Spatial Information Research
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    • v.6 no.2
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    • pp.133-152
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    • 1998
  • This article considers the experimental foundations of geographical phenomena for the distribution of lodging houses and the development of lodging Information Systems in Shin-Chon Area. This system allows the rural students to find their lodging houses conveniently. We examine the geographical reality of lodging houses in Shin-chon area and explores the lodging information system, reflecting how students select the lodging houses. Criteria for selection of lodging houses are travel time to school, interior facilities, rent fee, members, owners of lodging houses, which are collected by field swvey. The lodging information system is built in integration of Visual Basic with spatial data which are created in Mapinfo and Arcview through MapObject, component GIS software. This system provide query tools to efficiently investigate data as well as interactive map display. Also it displays the characteristics of a selected lodging houses using the identify tool on the map.

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Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Analysis on the Effect of the Dental Health Characteristics of Adult on the Status of Recognition and Practical Application of Dental Hygiene Devices (성인의 구강건강 특성이 구강위생용품의 인지도와 사용 실태에 미치는 영향)

  • Lee, Eun-Ju;Lee, Mi-Oak
    • Journal of dental hygiene science
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    • v.10 no.4
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    • pp.241-250
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    • 2010
  • The purpose of this study, which was processed from March $22^{nd}$ to April $9^{th}$ of 2010, was to figure out recognition, well-formed instructions, and Practical application about dental hygiene devices based on the dental health characteristics of 350 adults who dwell in Busan and Gyeongnam regions. Also, this study recommended the adults to use dental hygiene devices and provided such devices to help individuals take care of their dental health at home. The collected data was statistically processed with a statistics SPSS (Statistical Packages for Social Science 14.0. SPSS Inc. USA) program. First of all, in order to demonstrate the characteristics of the sample population statistics and that of the descriptive data, frequency analysis was performed and to find out the relationship between variations of the dental health, Chi-squared test through Crosstabs was operated. According to the study, recognition and Practical application of dental hygiene devices were very low. Therefore, public announcement about necessity and effectiveness of such devices should be reinforced nationwide and instructions on choosing the right device and using of the dental hygiene devices based on patients' conditions by dental hygienic human efforts gathered from dental health organization should be carried out.

A Study on the Status of Recognition and Practical Application of Oral Hygiene Devices : with outpatient as the central figure (치과병·의원 내원환자의 구강위생용품에 대한 인지도 및 사용실태에 관한 연구)

  • Kim, Soo-Kyung
    • Journal of dental hygiene science
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    • v.2 no.2
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    • pp.95-103
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    • 2002
  • This study was carried out to investigate recognition level and practical application status of oral hygiene devices through making a survey of Seoul inhabitants. And survey was implemented in order to propose oral hygiene device for household health care activities. The following results were obtained by analyzing personal interviews of 347 commuting patients at two university hospitals and seven dental clinics. 1) The average length of toothbrush head was estimated as 22.3 mm and average changing cycle was 2.3 months. The user ratio of flat-headed brush was estimated as 51.9% and 46.7% were using fluoridated toothpaste. 2) Generally the ratio of toothpick users was higher than other device users. But the user ratio of dental floss was higher than toothpick in case of patients under orthodontic treatment. 3) The patients under orthodontic treatment were not familiar with handling orthodontic toothbrush. Though 45.8% among orthodontic patients recognized this type of toothbrush, only 25.4% of them knew how exactly to use it. 4) It was shown very low user ratio of oral hygiene devices that the patients who had periodontal problem, hypersensitive trouble, halitosis, implant or denture 5) The patients who had halitosis showed the highest user ratio of toothpick. The patients who had separation of teeth showed the highest user ratio of dental floss. The patients who're under orthodontic treatment showed the highest user ratio of interproximal brush and motorized brush. 6) In response to the most interesting dental disease, it's surveyed as follows; 60.3% of dental caries, 24.0% of periodontal disease, 14.8% of false occlusion and 0.9% of oral cancer. 7) Regarding the motivation of using those oral hygiene devices, 45% responded that it was because of recommendation by dental clinics. Among the negative answers, 38.6% responded that it was because of no selection guidance. 31.3% answered that they didn't use hygiene device because it's inconvenient. 12.0% answered that it's difficult to buy and expensive. 7.8% responded that they didn't feel significant improvement. 4.8% answered that dental hospitals and clinics didn't even introduce those hygiene devices. Therefore efficient campaign for those hygiene devices over all Korea nation should be developed and education program must be prepared for each case of patients in every dental hospitals and clinics.

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Study of Dental Hygienist's Stress Degree and Adaptation Method (치과위생사의 스트레스 정도와 적응 방법에 관한 연구)

  • Gwon, Mi-Young;Jung, Mee-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.133-140
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    • 2004
  • It examines closely the occupation characteristic primary factor which the dentistry hygienic company field which is working to presence at a sickbed is undergoing the degree and from the research which it sees and it grasps the adaptation method against it gropes bitterly with development of the dentistry hygienic company individual to join in, it contributed in dentistry medical treatment service quality improvement and the research which tries to sleep it attempted. Currently the dentistry hygiene which works from Seoul and the condition area subject matter dentist unit, the dentistry hospital and the general hospital dentistry back it did in the object which it will burn. 116 issues which become frequency in question 120 it used SPSS 10.0 and it analyzed. Result of this study is as following. (1) Was expose that stress degree by factor feels about commonness on the whole, and angle prospects and support connection stress at company were the biggest item by item, and appeared as on the other hand relation connection stress with patient is the smallest. (2) Stress that stress degree by each receives in case of there are a lot of other businesses to characteristic businesses except appeared highest. On the other hand, was expose that feel the lowest stress degree an item that other a type of occupation and discord are. (3) 'Do action of that throw goods or closes the door bump' appeared article highest by short term adaptation method about stress, and 'Think and gives up by fate' appeared highest by special skill adaptation method. Short term adaptation method appeared high than special skill adaptation method on the whole but the difference appeared as is very small. (4) Stress degree comparison by general special quality was shown difference that stress by only dental hygiene administration of justice selection motive keeps in mind. (5) All of the result that compare short term, long term adaptation method about stress that feel new dental higienist apple career dental higienist same difference be, but displayed high result in same munhang. (6) Was expose that difference that keep in mind from all arguments in comparison of short term adaptation method by general special quality does not exist, on the other hand, comparison of long-term adaptation method displayed result that religion among only variable keeps in mind statistically.

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A Study on the Dental Hygienists' Reactions to Noise When Occurred in Dental Clinic (치과병원에서 발생하는 소음에 대한 치과위생사의 반응)

  • Choi, Mi-Suk;Ji, Dong-Ha
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.453-459
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    • 2009
  • The purposes of this research were to evaluate the relationships of between characteristics of noise and annoyance of dental hygienist by noise in dental clinic. To investigate the dental clinic workers' reactions to noise when occurred in dental clinic, the noise level test in dental clinic and questionnaire were taken. As a result of noise evaluation, It shows that the range of noise level was 67.7~78.3dB(A) and frequency was very high (more than 4KHz). It's seem to be begins occurrence of stamina-loss, contraction of peripheral blood vessel, decrease of adrenocortical hormones. Most of respondents were affected by noise: 67% of respondents were nervous about noise and the rest of respondents were bearable. Analysis by NR-curve showed that it was exceed the noise permit level in working space. As a result of correlation - test, the more exposed dental hygienist to noise, the more felt the unpleasantness and fatigue. It's hard to sufficient explanation to patients about the dental treatment. So it's thoughts that insufficient explanation will negative impact on the patients' satisfaction and increase competitiveness in dental clinics. To remedy a unpleasantness and fatigue of noise in dental hygienist, it's considered that making an offer the ear protection and choosing the low noise-vib. equipment and using the masking effect. Therefore, It can be provide a pleasant working environment with dental hygienist and It will have a great advantage to dental clinics to improve their competitiveness.

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Evaluation on Organ Dose and Image Quality of Lumbar Spine Radiography Using Glass Dosimeter (유리선량계를 이용한 요추검사의 장기선량 및 영상의 평가)

  • Kim, Jae-Kyeom;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.1-11
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    • 2016
  • The purpose of this study was to provide resources for medical exposure reduction through evaluation of organ dose and image resolution for lumbar spine around according to the size of the collimator in DR system. The size of the collimator were varied from $8^{\prime\prime}{\times}17^{\prime\prime}$ to $14^{\prime\prime}{\times}17^{\prime\prime}$ by 1" in AP and lateral projection for the lumbar spine radiography with RANDO phantom. The organ dose measured for liver, stomach, pancreas, kidney and gonad by the glass dosimeter. The image resolution was analyzed using the Image J program. The organ dose of around lumbar spine were reduced as the size of the collimator is decreased in AP projection. There were no significant changes decreasing rate whenever the size of the collimator were reduced 1" in the gonad. The organ dose showed higher on liver and kidney near the surface in lateral projection. There were decreasing rate of less than 5% in liver and kidney, but decreasing rate was 24.34% in the gonad whenever the size of the collimator were reduced 1". Organ dose difference for internal and external of collimator measured $549.8{\mu}Gy$ in the liver and $264.6{\mu}Gy$ in the stomach. There were no significant changes organ dose difference that measured $1,135.1{\mu}Gy$ in the gonad. Image Quality made no difference because SNR and PSNR were over than 30 dB when the collimator size is less than $9^{\prime\prime}{\times}17^{\prime\prime}$ on AP projection and $10^{\prime\prime}{\times}17^{\prime\prime}$ on lateral projection. Therefore, we are considered that the recommendations criterion for control of collimator were suggested in order to reduce unnecessary X-ray exposure and to obtain good image quality because lumbar spine radiography contains a lot of peripheral organs rather than other area radiography.