• Title/Summary/Keyword: 입원환자 관리

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A Keyword Network Analysis of Standard Medical Terminology for Musculoskeletal System Using Big Data (빅데이터를 활용한 근골격계 표준의료용어에 대한 키워드 네트워크 분석)

  • Choi, Byung-Kwan;Choi, Eun-A;Nam, Moon-Hee
    • Journal of Digital Convergence
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    • v.20 no.5
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    • pp.681-693
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    • 2022
  • The purpose of this study is to suggest a plan to utilize atypical data in the health care field by inferring standard medical terms related to the musculoskeletal system through keyword network analysis of medical records of patients hospitalized for musculoskeletal disorders. The analysis target was 145 summaries of discharge with musculoskeletal disorders from 2015 to 2019, and was analyzed using TEXTOM, a big data analysis solution developed by The IMC. The 177 musculoskeletal related terms derived through the primary and secondary refining processes were finally analyzed. As a result of the study, the frequent term was 'Metastasis', the clinical findings were 'Metastasis', the symptoms were 'Weakness', the diagnosis was 'Hepatitis', the treatment was 'Remove', and the body structure was 'Spine' in the analysis results for each medical terminology system. 'Oxycodone' was used the most. Based on these results, we would like to suggest implications for the analysis, utilization, and management of unstructured medical data.

A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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Lymphocyte Subpopulations and Proliferation of T cells, Phagocytic Activity of Leukocytes on Alcoholics (알코올중독자의 백혈구탐식능, 림프구아형 및 증식능)

  • 김용호;서병배;이정녀;김영훈
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.167-174
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    • 1996
  • Alcoholics increased susceptibility to microbial infection that is associated with decreased immunity. but there has been little experimental evidence to support alcoholics-induced increase of microbial infection directly in non-specific immunity. Therefore, we were used the method of phagocytic-plaque including all the stimulating factors for the phagocytosis, subtypes of lymphocytes and T-lymphocyte proliferation. The experimental groups were divided into 3 groups: (1) alcoholics who were hospitalized less than 1 week (newly hospitalized alcoholics), (2) alcoholics who were hospitalized more than 2 weeks (old hospitalized alcoholics), (3) healthy blood donors. We have studied 98 alcoholics and 35 healthy blood donors and control groups. A physician has checked the biological markers and diagnosed the body-condition alcoholics. The immunity and non-specific immunity on the alcoholics were analyzed by using the simultest kit and flow cytometry. Proliferation of the lymphocytes was analyzed by the phytohemmagglutinine mitogen. Phagocytosis and migration properties of leukocytes were identified on the layer formed by Staphylococcus aureus Cowan I strain. Biological markers of alcoholics and control groups, by such as blood glucose, ${\gamma}$-glutamyl transpeptidase and mean corpuscular volumes of red blood cells, were determined by biochemical and hematological methods. Compared with control groups, cluster of differentiation (CD)3+, CD8+ and CD19+ in alcoholic were more decreased except CD4+/CD8+ ratio. Proliferation of the T-lymphocytes, phagocytosis and migration properties of the leukocytes in alcoholics were decreased compared with those of control groups. According to the results observed in our experiment, they can be summerized as follows: 1, Cellular, humoral and non-specific immunities, are markedly decreased in alcoholics than those in control groups. 2. It is inferred that Phagocytic plaque formation is a very useful method to evaluate phagocytosis and migration properties of the alcoholic leukocytes 3. It is thought that the subtypes of lymphocytes, especially CD4+/CD8+ ratio, are essential methods to analyzed the alcoholic immunity. 4. Specific and non-specific immunity on the old hospitalized alcoholics was slightly increased, which depends upon the alcoholic medication.

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Clinecal Investigation and Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum (전흉벽 늑연골의 리모델링 성형술을 이용한 누두흉수술의 임상적 고찰 초기합병증)

  • Her, Keun;Song, Cheol-Min;Jeon, Cheol-Woo;Jang, Won-Ho;Kim, Hyun-Jo;Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.882-889
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    • 2002
  • Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus excavatum Recently, Remodelling Plasty of Costochondral Rib Cage has been introduced as an minimally invasive procedure and expanded its application for pectus excavatum. Outcomes and acute complications were reviewed Material and Method: A retrospective survey of 55 patients who underwent Remodelling Plasty of Costochondral Rib Cage from September, 1999 to February, 2002 was conducted to review complications, postoperative treatments, and outcomes. Result: Age ranged from 1 to 27 years(mean 11.4 $\pm$ 7.1). 35(64%) were less than 15-year old and 20(36%) were more than 15-year old. There were 44(80%) Male patients and 11(20%) female patients. Length of hospital stay was 7.8 $\pm$ 2.1 days for less than 15-Y-old group, 10.6 $\pm$ 6.2 days for more than 15-Y-old group(p = 0.042) One substernal bar was inserted in 52 patients and two substernal bars were inserted in 3 patients. As for stabilizer, one lateral side was fastened in 15 patients and both lateral sides were fastened in 6 patients. In the less than 15-Y-old group, 4 patients needed stabilizer, whereas in the more than 15-Y-old group, 18 patients needed stebilizer(s)(p = 0.000). Including all kinds of complications, 28(51 %)patients had postoperative complications. Of them, only 7 patients were treated for complications(C-tube insertion was done in 7 patients and reoperation for bar refixation or removal was done in 3 patients of them). Conclusion: Most complications after Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum were trivial without treatment although C-tube drainage was needed in some patients. However bar displacement such as rotation and lateral sliding should be corrected as soon as detected in order not to remove the bar(the worst situation).

The Effect of 131I Therapy by Taking in Laxatives (방사성요오드 치료 시 완하제 투여 효과)

  • Kil, Sang-Hyeong;LEE, Hyo-Yeong;Park, Kwang-Yeol;Jo, Kyung-Nam;Baek, Seung-Jo;Hwang, Kyo-Min;Cho, Seong-Mook;Choi, Jae-Hyeok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.3-9
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    • 2014
  • Purpose: Our goals were to evaluate the effect of high dose radioiodine treatment for thyroid cancer by taking in laxatives. Materials and Methods: Twenty patients(M:F=13:7, age $46.3{\pm}8.1\;yrs$) who underwent high dose radioiodine treatment were seperated into Group 1 taking $^{131}I$ 5,500 MBq and Group 2 with the use of laxatives after taking $^{131}I$ 5,500 MBq. The whole body was scanned 16 hours and 40 hours after taking radioactive iodines by using gamma camera, the ROIs were drawn on the gastro-intestinal tract and thigh for calculation of reduction ratio. At particular time during hospitalization, the radioactivity remaining in the body was measured in 1 meter from patient by using survey meter (RadEye-G10, Thermo Fisher Scientific, USA). Schematic presentation of an Origin 8.5.1 software was used for spatial dose rate. Statistical comparison between groups were done using independent samples t-test. P value less than 0.05 was regarded as statistically significant. Results: The reduction ratio in gastro-intestinal 16 hours and 40 hours after taking laxatives is $42.1{\pm}6.3%$ in Group 1 and $72.1{\pm}6.4%$ in Group 2. The spatial dose rate measured when discharging from hospital was $23.8{\pm}6.7{\mu}Sv/h$ in Group 1 and $8.2{\pm}2.4{\mu}Sv/h$ in Group 2. The radioactivity remaining in the body is much decreased at the patient with laxatives(P<0.05). Conclusion: The use in combination with laxatives is helpful for decreasing radioactivity remaining in the body. The radioactive contamination could be decreased at marginal individuals from patients.

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Clinical Analysis of Acute Intrinsic Renal Failure in Neonates and Children (소아에서의 급성 신성신부전의 임상적 고찰)

  • Kwon, Eun-Ji;Jung, Ji-Mi;Chung, Woo-Yeung
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.30-37
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    • 2008
  • Purpose: The present study is an investigation of the progression and prognosis of acute intrinsic renal failure in neonates and children with a diagnosis of acute renal failure or other diseases on admission. Methods: This research is based on a retrospective analysis conducted on 59 patients(male: female=2.2:1) diagnosed with acute intrinsic renal failure between January 2000 and June 2006 at Busan Paik Hospital. The clinical diagnostic criteria of acute renal failure used was serum creatinine <1.2 mg/dL, oliguria with urine output$\leq$0.5 mL/kg/hr and anuria with urine output <50 mL per day. Results: Among those placed under investigation, 7 patients were neonates, 10 patients were 2 months-2 years old, 12 patients were 3-6 years old, 21 patients were 7-12 years old and 9 patients were 13-16 years old. It took 3.1${\pm}$2.8 days on average until the diagnosis was made. The urine output distribution was 21 persons for the oliguria group, and 36 persons for the non-oliguria group, and 2 persons for the anuria group. For the underlying causes, 30 persons were classified in the primary renal disease group, 14 persons in the infection group, 9 persons in the malignancy group, and 6 persons were categorized in another group. As for age distribution, the infected group was predominantly neonates, whereas the dominant age ranges for the primary renal disease and infection categories were 2 months to 2 years old. Also, the primary renal disease was dominant among older children, aged 3 and up. No difference was detected according to seasonal prevalence. However, there was a high morbidity rate among hemolytic uremic syndrome diagnosed in the summer. Peritoneal dialysis was used to treat 4 patients. It took 10.0${\pm}$6.7 days until the patients improved. 18 patients died. The non-oliguria group's mortality rate was lower than other groups. There was a high mortality rate in the neonates and malignancy group. Conclusion: Acute renal failure in childhood seems to take a better clinical course than in adulthood when there is an early diagnosis and proper treatment of underlying diseases.

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Factors Affecting to Adherence to Self-care Behaviors among Inpatients with Heart Failure in Korea (심부전 입원 환자의 자가관리 행위 이행에 영향을 미치는 요인)

  • Ok, Jong Sun;Ko, Il Sun;Ryu, Kyu Hyung;Kim, Sung Hea;Lim, Seo Jin
    • Journal of Korean Critical Care Nursing
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    • v.6 no.2
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    • pp.51-64
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    • 2013
  • Purpose: This study was to analyze adherence to self-care behaviors and identify factors affecting the adherence behaviors among inpatients with heart failure. Methods: A total 94 hospitalized inpatients from three hospitals participated in a survey. Data were collected using structured self-reported questionnaire from November 28, 2011 to March 31, 2013 and analyzed using frequency, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression. Results: The score of adherence to self-care behaviors among inpatients with heart failure was $26.02({\pm}8.84)$. Factors related to the adherence to self-care behaviors were living with spouse (t=-2.47, p=.019), functional state (t=2.18, p=.034), heart failure knowledge (r=-.49, p<.001), social support (r=-.35, p<.001), self-control (r=-.25, p=.016), and self-care confidence (r=-.24, p=.019). The factors affecting adherence to self-care behaviors were heart failure knowledge, self-care confidence, and social support. These factors explained 32% of the variance in adherence to self-care behaviors. Conclusion: The adherence to self-care behaviors with heart failure can be improved if heart failure knowledge, self-care confidence, and social support are improved. Therefore, developing a nursing intervention program for patient with heart failure that is considered these factors leads to improve quality of life and prevent readmission.

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A Study of Occurrence of Secondary Complications and Chronic Diseases due to Aging of Spinal Cord Injury (척수손상환자의 고령화에 따른 2차합병증 발생과 만성질환발병에 관한 연구)

  • Min, Yeo Jin;Kim, Jong Bae
    • 재활복지
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    • v.22 no.4
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    • pp.83-102
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    • 2018
  • The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

Epidemiological Characteristics of Patients with Drug-Resistant Tuberculosis (약제 내성 결핵 환자의 역학적 특징)

  • Lee, Jin-Hwa;Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.412-420
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    • 2000
  • Background : There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. Method : We studied 68 cases with drug-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. Results : Patients with primary drug-resistant tuberculosis(PDR) were younger (39.6$\pm$16.3 years vs. 48.2$\pm$16.5 years ; p<0.05), had more population of less than more were under the age of 40 years aged -group(62.9% vs. 36.4% ; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1% ; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0$\pm$0.8 vs. 1.4$\pm$0.7 ; p<0.01) and longer treatment duration than those with PDR(18.3$\pm$7.2 months vs. 10.6$\pm$6.3 months ; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly- and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4% ; p<0.05). Conclusions : Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.

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Clinical Characteristics of Tuberculosis in North Korean Refugees (북한이탈주민에서의 결핵의 임상적 고찰)

  • Choi, Chang-Min;Jeong, Woo-Kyoung;Kang, Cheol-In;Kim, Doh-Hyung;Kim, Young-Keun;Heo, Sang-Taek;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.285-289
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    • 2006
  • Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.