• Title/Summary/Keyword: 진료실

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A Survey of Student Satisfaction after Role Play using Syndrome Differentiation-based Clinical Performance Examination Scenario in Class of Korean Medical Classics (원전 수업에서 변증(辨證) 기반 진료수행시험(CPX) 시나리오를 이용한 역할극에 대한 학생 만족도 조사)

  • Hak-Jun, Jo;Na-young, Jo;Jeong-Su, Park
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.3
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    • pp.73-86
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    • 2022
  • Objectives : The purpose of this study was to investigate the satisfaction of students who participated in a role play using the syndrome differentiation CPX (Clinical Performance Examination) scenario in Korean Medicine Classics class, and to find out whether the results were correlated with self-assessment of treatment skills and subject achievement. Methods : In the Korean Medicine Classics class in the first semester of 2022, 44 first-year students in the Department of Korean Medicine completed theoretical education and formative evaluation on the subject of internal damage fever, and then role-played using CPX scenarios. Among them, 41 students consented to the study. Students who agreed to the study answered the satisfaction questionnaire consisting of 13 questions in 2 areas on learning methods and effects, and self-evaluation was conducted according to the evaluation items of medical technology consisting of 23 questions. Satisfaction and self-assessment results were analyzed for correlation, and additionally, correlation with Korean Medicine Classics subject achievement was also analyzed. Results : The result of student satisfaction with the role play was 4.87±0.06 while the result of student self-assessment of clinical skill was 4.73±0.16. The student satisfaction with the role play showed statisticallysignificant correlations with the self-assessment of clinical skill and quiz score of Korean Medical Classics while it did not show correlations with the total score of Korean Medical Classics and paper test. Also, the self-assessment of clinical skill did not show correlations with the total score of Korean Medical Classics, paper test, and quiz. Conclusions : Even though the students who performed the role play using the syndrome differentiation based CPX scenario highly assessed their clinical skill and showed high satisfaction, it did not show significant correlation with the achievement of Korean Medical Classics.

Tracing Per Ankh as a Prototype of Ancient Egytian Libraries (고대 이집트 도서관의 원형, 페르 앙크(Per Ankh) 추적)

  • Hee-Yoon Yoon
    • Journal of the Korean Society for Library and Information Science
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    • v.57 no.4
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    • pp.5-24
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    • 2023
  • In ancient Egypt, temples were not only religious sanctuaries but also community centers. One of the core spaces created in the temple is the facility where priests and scribes copied and preserved texts on papyrus and other media. Its common designation was 'pr-mḏȝ'(House of Books) and the 'per-(nw)-seshw'(House of Scrolls). The general term used during that time was 'Per Ankh', and the modern term for it is 'temple library'. Therefore, this study first identified the character and identity of the Per Ankh attached to the temple, and then traced whether it is appropriate to designate 'healing place of the souls' depicted on the hypostyle hall(Per Ankh) in the Ramesseum(mortuary temple) built by Ramses II of the New Kingdom as a library. As a result, Per Ankh, a hieroglyph combining the Per(house) and Ankh(life), was revealed to be a multi-purpose complex facility consisting of a learning and research center, a treatment and healing center with medical facilities and sanatoriums, a religious ceremony and a center for the celebration of eternal life, a scriptorium and a library. Therefore, the traditional argument that Per Ankh refers to a library cannot be justified. In the same context, the inscription 'Ψυχῆς ἰατρεῖον' on the doorplate of the hypostyle hall of the Ramesseum, which was first introduced by Greek historian Hecataeus of Miletus in the 4th century BC, was translated into Latin as 'Psychēs Iatreion' by Diodorus Siculus in the 1st century BC and described as the motto of the sacred library. However, Psyche is the goddess of Greek and Roman mythology, and Iatreion means hospital(clinic, healing center) and pharmacy, so Per Ankh in the Ramesseum is a space to heal the soul of the pharaoh (Ka). Therefore, 'Psychēs Iatreion = library' is a distortion and a mistranslation. It is not the motto of the library, but a metaphor for the Per Ankh.

A Study on Appropriate Nurse Staffing Levels in Intensive Care Units and Improvement of the Critical Care Nursing Fee Schedules (중환자실 적정 간호사 배치수준과 간호관리료 차등제 개선 연구)

  • Lee, Hyo Jin;Cho, Sung-Hyun;Shim, Mi Young;Kim, Jung Yeon;Song, Yu Gil;Kim, Jin;Kim, Young Sam
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.312-326
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    • 2023
  • Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

Diagnostic Conundrum: Fever and Pyuria Preceding Diagnosis of Kawasaki Disease in Children

  • Jiseon Park;Young June Choe;Seung Ah Choe;Jue Seong Lee;Hyung Eun Yim;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.139-144
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    • 2023
  • Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

Electronic Cigarette or Vaping Product Use-Associated Lung Injury: A Case Report (전자담배 관련 급성 폐 손상: 증례 보고)

  • Jiyun Lim;Bo Da Nam;Jung Hwa Hwang;Yang-Ki Kim;Eunsun Oh;Eun Ji Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1581-1588
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    • 2021
  • Electronic cigarette (e-cigarette) or vaping product use-associated lung injury (EVALI) has emerged as a social issue as e-cigarette use is rapidly increasing worldwide and is related to many deaths in the United States. To our knowledge, this is the first case report of EVALI in South Korea of a 24-year-old man with acute respiratory symptoms and a history of e-cigarette use. Chest CT revealed diffuse bilateral ground-glass opacities with subpleural sparing, airspace consolidation, and centrilobular micronodules as typical patterns of EVALI with organizing pneumonia and diffuse alveolar damage. Infection was excluded with meticulous laboratory examinations, and the patients' illnesses were not attributed to other causes. EVALI was diagnosed by meeting the diagnostic criteria with consistent clinico-radiologic findings through a multidisciplinary approach. Radiologists should have good knowledge of EVALI radiologic findings and play a cardinal role in the proper diagnosis and management of EVALI.

Comparison of Integrated Health and Welfare Service Provision Projects Centered on Medical Institutions (의료기관 중심 보건의료·복지 통합 서비스 제공 사업 비교)

  • Su-Jin Lee;Jong-Yeon Kim
    • Journal of agricultural medicine and community health
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    • v.49 no.2
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    • pp.132-145
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    • 2024
  • Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.

A Study on the Environmental Condition and Safety in Dental Radiographic Room (치과 방사선 촬영실의 촬영실태와 방사선 안전관리 실태에 관한 조사 연구)

  • Kang, Eun-Ju;Lee, Kyung-Hee;Ju, On-Ju
    • Journal of dental hygiene science
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    • v.5 no.2
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    • pp.83-88
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    • 2005
  • In spite of relatively low level of radiation dose used at dental clinics, long term exposure may be harmful, so radiation workers at dental clinics must be well aware of its danger. This study was radiation safety management by dental hygienists in order to take preventive measures for dental hygienists and suggest ideas to develop radiation safety training programs. For this, we contacted dental hygienists working at the local dental clinics for 4 months from December of 2003 to march of 2004 and obtained the following findings. 1. Regarding the intraoral radiographic method, the average daily photographing frequency of standard films stood at one to five pieces (47.5%), and the average weekly photographing frequency of digital radiation medicine stood at less than one piece (69.8%), and the average weekly photographing frequency of bitewing films stood at less than one piece (67.7%), and and the average weekly photographing frequency of occlusal films stood at less than one piece (95.5%), and the dentistries whose average weekly photographing frequency of pediatric films stood at one to five pieces accounted for 47.1 percent. 2. Regarding the extraoral radiographic method, the average weekly photographing frequency of panorama film stood at one to five pieces (63.7%), and less than one piece (20.9%), the average weekly photographing frequency of cephalometric film stood at less than one piece (72.3%), and one to five pieces (20.1%). 3. Concerning the radiation safety management training program, only 18.7% of total 278 surveyed attended the training progra., Attendance tendency of the training program by general characteristics showed statistically significant difference according to age (p<0.01), working experience (p<0.001), and marital status (p<0.01). 4. When asked about the protective equipments against radiation exposure, 40.6% of them said "modest", and 71.1% appeared equipped with led apron as a protective tool.

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Consultations to Department of Dentistry for Child and Adolescent Inpatients with Dental Trauma (치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰)

  • Jo, Chanwoo;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.403-411
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    • 2017
  • The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

Evaluation of Reliability about Short TAT (Turn-Around Time) of Domestic Automation Equipment (Gamma Pro) (국산 자동화 장비(Gamma Pro)의 결과보고시간 단축에 대한 유용성 평가)

  • Oh, Yun-Jeong;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.197-202
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    • 2010
  • Purpose: Recently, many hospitals have been tried to increase the satisfaction of the outpatients through blood-gathering, exam, result notice and process in a day. Each laboratory has been used the automatic equipment for the rapid requests of the result notice and the increase of the reliability and efficiency. Current automatic equipments that have been limited short TAT(Turn-Around Time)because of the restricted batch lists and 1 tip-5 detectors. The Gamma Pro which is made in Korea to improve the shortcomings of existing automation equipment, complemented with capacity to perform a wide range of domestic automation equipment. In this study, we evaluated the usefulness and reliability of short TAT by comparing Gamma Pro with current automatic equipment. Materials and Methods: We studied the correlation between Gamma Pro and RIA-mat 280 using the respective 100 specimens of low or high density to the patients who were requested the thyroid hormone test (Total T3, TSH and Free T4) in Samsung Medical Center Sep. 2009. To evaluate the split-level Gamma Pro, First, we measured accuracy and carry over on the tips. Second, the condition of optimal incubation was measured by the RPM (Revolution Per Minute) and revolution axis diameter on the incubator. For the analysis for the speed of the specimen-processing, TAT was investigated with the results in a certain time. Result: The correlation coefficients (R2) between the Gamma Pro and RIA-mat 280 showed a good correlation as T3 (0.98), TSH (0.99), FT4 (0.92). The coefficient of variation (C.V) and accuracy was 0.38 % and 98.3 % at tip 1 and 0.39 % and 98.6 % at tip 2. Carry over showed 0.80 % and 1.04% at tip 1 and tip 2, respectively. These results indicate that tips had no effect on carry over contamination. At the incubator condition, we found that the optimal condition was 1.0mm of diameter at 600RPM in 1.0mm and 1.5mm of at 500RPM or 1.0mm and 1.5 mm of diameter at 600 RPM. the Gamma Pro showed that the number of exam times were increased as maximum 20 times/day comparing to 6 times/day by current automatic equipment. These results also led to the short TAT from 4.20 hour to 2.19 hours in whole processing. Conclusion: The correlation of between the Gamma Pro and RIA-mat 280 was good and has not carry over contamination in tips. The domestic automation equipment (Gamma Pro) decreases the TAT in whole test comparing to RIA-280. These results demonstrate that Gamma Pro has a good efficiency, reliability and practical usefulness, which may contribute to the excellent skill to process the large scale specimens.

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Dose Rate of Restroom in Facilities using Radioisotope (방사성동위원소 사용시설(내/외) 화장실의 외부선량률)

  • Cho, Yong-Gwi;An, Seong-Min
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.237-246
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    • 2016
  • This study is therefore aimed at measuring the surface dose rate and the spatial dose rate in and outside the radionuclide facility in order to ensure safety of the patients, radiation workers and family care-givers in their use of such equipment and to provide a basic framework for further research on radiation protection. The study was conducted at 4 restrooms in and outside the radionuclide facility of a general hospital in Incheon between May 1 and July 31, 2014. During the study period, the spatial contamination dose rate and the surface contamination dose rate before and after radiation use were measured at the 4 places-thyroid therapy room, PET center, gamma camera room, and outpatient department. According to the restroom use survey by hospitals, restrooms in the radionuclide facility were used not only by patients but also by family care-givers and some of radiation workers. The highest cumulative spatial radiation dose rate was 8.86 mSv/hr at camera room restroom, followed by 7.31 mSv/hr at radioactive iodine therapy room restroom, 2.29 mSv/hr at PET center restroom, and 0.26 mSv/hr at outpatient department restroom, respectively. The surface radiation dose rate measured before and after radiation use was the highest at toilets, which are in direct contact with patient's excretion, followed by the center and the entrance of restrooms. Unsealed radioactive sources used in nuclear medicine are relatively safe due to short half lives and low energy. A patient who received those radioactive sources, however, may become a mobile radioactive source and contaminate areas the patient contacts-camera room, sedation room, and restroom-through secretion and excretion. Therefore, patients administered radionuclides should be advised to drink sufficient amounts of water to efficiently minimize radiation exposure to others by reducing the biological half-life, and members of the public-family care-givers, pregnant women, and children-be as far away from the patients until the dose remains below the permitted dose limit.