• Title/Summary/Keyword: 진료실

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Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

Latest Supreme Court Decision on Proof of Causation in Medical Malpractice Cases - Focusing on Supreme Court decision 2022da219427 on August 31, 2023 and the Supreme Court decision 2021Do1833 on August 31, 2023 - (의료과오 사건에서 인과관계 증명에 관한 최신 대법원 판결 - 대법원 2023. 8. 31. 선고 2022다219427 판결 및 대법원 2023. 8. 31. 선고 2021도1833 판결을 중심으로 -)

  • HYEONHO MOON
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.3-36
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    • 2023
  • The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

Change in Quality of Tuberculosis (TB) Care since National Quality Assessment Program of TB Healthcare Service (결핵 적정성 평가에 따른 국내 결핵 진료서비스 질 관리 현황)

  • Jang, Seong-Ja;Hwang, Mi-Jin;Lee, Chung-Hun;Lee, Hyeon-Ju;Shim, Tae-Sun;Kim, Dong-Sook
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.73-82
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    • 2021
  • Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted. Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy). Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%. Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

MIDAZOLAM ORAL PREMEDICATION IN AUTISTIC PATIENT WHO IS AFRAID TO ENTER DENTAL OFFICE -A CASE REPORT- (치과 진료실에 들어오지 않으려는 자폐환자에서 미다졸람 경구투여 -증례보고-)

  • Lee, Jung-Hoo;Seo, Kwang-Suk;Shin, Teo-Jeon;Kim, Hyun-Jeong;Chang, Ju-Hea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.2
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    • pp.100-103
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    • 2009
  • Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.

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A review of biocompatibility of zirconia: In vitro experiment (지르코니아의 생체적합성에 대한 연구: In vitro 실험 문헌 고찰)

  • Suh, Da-Won;Kim, Young-Kyun;Yi, Yang-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.391-395
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    • 2018
  • Increasing demands for zirconia material in clinics, assessment of biocompatibility of zirconia is essential. In this article, a review of in vitro studies of zirconia compatibility was performed. Zirconia showed great biocompatibility at in vitro studies with various cell lines such as fibroblasts, osteoblasts, and lymphocytes. Many studies reported that zirconia caused no cytotoxicity or mutation. Zirconia also showed less bacterial adhesion. There were no adverse effects except for small reduced strength with in vitro study mimicking long-term exposure of body fluid. According to the study with ostoblast-like cells, zirconia could regulate genes of immunity, molecular transport, and cell cycle. Such gene regulating was considered as one of the reasons of zirconia biocompatibility. With biocompatibility of zirconia powders, in vitro studies had controversial conclusions. It seems that zirconia powders might have cytotoxicity.

The proposal about the effective management of outside data (외부 병원 Data의 효율적 관리에 대한 제언)

  • Lee, Hwa-Sun;Lee, Rae-Gon;Kang, Ji-Yeon;Hwang, Sun-Kwang
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.31-35
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    • 2007
  • 외부 데이터가 진료병원 Server에 저장됨에 있어서 판독을 의뢰하지 않을 경우, 대부분의 병원이 무상으로 이루어 지고 있는 상황이며 이에 외부 데이터 단순 import의 효율적인 관리를 위한 수가 적용 여부를 검토하였다. 2007년 3월부터 4월까지 서울 경기 지역의 PACS가 도입 된지 1년 이상, 병상 수 500Bed 이상의 종합 대학병원 25곳에 근무하는 각 병원의 PACS 운영실 및 PACS 관리자를 대상으로 하였다. 외부 데이터에 관한 10가지 항목의 설문지를 작성하여 각 병원의 PASC 담당자 및 관리자를 대상으로 E-mail을 이용한 자기 기입 방식, 전화를 통한 질의응답 방식으로 조사하였다. 조사된 25개의 종합 대학병원의 96%이상이 외부 데이터 단순 import를 지원하고 있었으며, 그 중 92%의 병원은 무상으로 이루어지고 있었다. 이와 같이 진행 되는 부분에 대하여 각 병원의 PACS 담당자 70% 이상이 단순 import에 대한 수가 적용의 필요성을 느끼고 있으며, 현재 많은 병원에서 단순 import의 무상 지원으로 인한 문제점을 인식하고 있었다. K병원을 기준으로 단순 import에 년간 H/W 소요 비용은 336만원이고, 년간 인건비 소요비용은 421만원이다. 또한 단순 import 한 건당 평균 데이터 size는 48MB 정도로 조사되었다. 환자 입장에서 진료에 참고자료로 사용 될 외부 데이터의 정확한 저장과 정당한 PACS 사용을 위해서는 그에 상응하는 수가가 적용 되어야 할 것이다. 보험심사평가원 급여기준에 따라 수가적용이 인정되어 의료영상 디지털화로 인한 초기의 고액 투자비용 보장과 회수를 위해 단순 Import의 수가 적용이 반드시 필요하다고 사료 된다.

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Work reality of dental assistant (치과에 근무하는 치과보조인력의 업무실태)

  • Lee, Sook-Jeong;Cho, Hye-Yeon
    • Journal of the Korea Convergence Society
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    • v.6 no.4
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    • pp.153-159
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    • 2015
  • Dental assistant in South Korea, The work is overlapped considerably between dental hygienist and dental practical nurse. Moreover, dental technician, hospital coordinator work in dentistry consultation deeply. It cause friction among work scope of occupation's type. Accordingly It is purpose to get basic data which is necessary to deduce division of work training and utilization of human resources in oral health distinguish clearly between business occupations. Also compared and analyzed via analysis of frequency and ANOVA above 10 works around something legal work of dental hygienist regarding work reality of dental assistant in dental clinic and hospital. Compare with scaling, representative item about 10 works center on legal work of dental hygienist, is implementing dental technician 9(75%), practical nurse 64(87.67%), etc. 11(64.71%). Dental assistant except dental hygienist is implementing indigenous legal work of dental hygienist. Dental institution secure enough man power, It is suggested necessity for policy means regarding role and work scope of dental assistant.

The LMOF Preprocessing Tool for Mapping Laboratory Vocabulary to LOINC in Clinical Document Architecture (임상문서표준규격내 검사실 용어의 LOINC 매핑을 위한 LMOF 전처리 도구)

  • Do, Hyoung-Ho;Kim, Il-Kon;Lee, Sung-Kee;Kwak, Yun-Sik
    • Journal of KIISE:Computer Systems and Theory
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    • v.35 no.4
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    • pp.158-165
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    • 2008
  • LOINC (Logical Observation Identifiers Names and Codes) is a database and universal standard for identifying laboratory and clinical test results that is developed and maintained by Regenstrief Institute. Exchanging laboratory test results is one of the most important area in EHR system and the terminology for laboratory test results has to be standardized. In this paper, we present a pre-preprocessing tool that converts a local database in healthcare organizations to LMOF format LMOF format is required by RELMA and our work helps mapping laboratory test results to LOINC very efficiently Our proposed tool provided user friendly interface and 15% keyword reduction in RELMA search compared to no pre-processing RELMA search.

The frog appliance for upper molar distalization: a case report (Frog appliance를 이용한 상악 대구치의 원심 이동: 증례 보고)

  • Bayram, Mehmet;Nor, Metin;Kilkis, Dogan
    • The korean journal of orthodontics
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    • v.40 no.1
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    • pp.50-60
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    • 2010
  • The purpose of this article was to evaluate the effects of a new upper molar distalization system, the Frog Appliance, on dentofacial structures in a Class II, division 1 patient. An 11-year-old girl was referred to our clinic for orthodontic treatment. She had a mild skeletal Class II malocclusion with Class II molar and canine relationship on both sides. The treatment plan included distalization of the upper first molars bilaterally followed by full fixed appliance therapy. For the upper molar distalization, a new system, the Frog Appliance, was constructed and applied. Lateral cephalometric radiographs were used to evaluate the treatment results. Distalization of the upper first molars was achieved in four months successfully, and Class I molar relationship was obtained. Total treatment time was 16 months. According to the results of the cephalometric evaluation, a nearly bodily distal molar movement with a slight anchorage loss was attained. In conclusion, the Frog Appliance was found to be a simple, ef ective, non-invasive, and compliance-free intraoral distalization appliance for achieving bilateral molar distalization.

Convergence Assessment of the Salivary Relationship between dental caries and periodontitis among the University students. - Sill-Ha ST-4910 Salivary Testing Instrument - (일부 여대생의 치아우식병과 치주병 예측을 위한 타액의 융합적 평가 - 타액측정시스템(Sill-Ha ST-4910)이용 -)

  • Choi, Eun-Mi;Kim, Young-Hee
    • Journal of the Korea Convergence Society
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    • v.11 no.7
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    • pp.273-280
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    • 2020
  • Upon investigating the dental health of teeth and gum, and the cleanliness of the oral cavity of female college students in the early 20's, it was reported to be that the number of cariogenic bacteria was heavily related to the acidity of saliva or ammonia. Also, cariogenic bacteria and ammonia was found out to be related with proteins (p<0.01), and ammonia, the synthetic product of cariogenic bacteria was heavily related to blood and white blood cells (p<0.01). To conclude, the healthiness of teeth was related to the acidity of saliva and ammonia, the healthiness of gum was related to blood, proteins and white blood cells while the oral hygiene was most likely to be related to ammonia. This result matched to the seven oral disease cause analyses of the saliva analysis apparatus (Sill-Ha ST-4910), which implied further utilization of this data to clinical implications. However, this study is limited to young personnel who does not have any chronic or general diseases; therefore further study is required to generalize this study.