• Title/Summary/Keyword: 진료실

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Prevalence and Treatment Pattern of Korean Patients with Temporomandibular Disorders (한국인 턱관절장애 환자의 유병률과 진료 양태)

  • Yang, Hee-Young;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.63-79
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    • 2009
  • While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.

Correation between Microalbuminuria Checked by RIA & Micral - Test$^{(R)}$ (방사면역측정법 및 MICRAL-TEST$^{(R)}$ 로 측정한 미세단백요 사이의 상관관계에 대한 연구)

  • Lee, Chan-Woo;Won, Kyu-Chang;Choi, Soo-Bong
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.158-163
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    • 1991
  • It is evident that an elevation of airway albumin excreation rate without clinical proteinuria strongly predicts a later progression on diabetic renal disease. So we studied the correation between Microalbumin checkly RIA & Mitral-Test$^{(R)}$. We collected urine between 08 : 00 h and 08 : 00 h next day and then checked microalbuminuria by radioimmunoassay method and Mitral-Test$^{(R)}$ The results are as follows : 1. There was significant correation between microalbuminuria checked by RIA & Micral-Test$^{(R)}$ 2. There was poor correations between diabetes duration or HV-A1c and maximal change in albumin excreation rate. 3. So we conclued that Micral-Test$^{(R)}$ can be used in laboratory instead of RIA.

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Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room (암성통증관리지침 적용 전후 긴급진료실 내원 환자의 통증관리 비교)

  • Won, Young-Hwa;Kim, Yeon-Hee;Park, Jeong-Yun
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.230-236
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    • 2012
  • Purpose: This study was to investigate the effect of the application of cancer pain management guidelines on pain management among patients in Cancer Emergency Room. Methods: This study was a retrospective descriptive study. Before application, data were collected by analyzing the Electronic Medical Record in Cancer Emergency Room in September, 2011, and after application in February, 2012. The subjects of this study consisted of 231 patients (pre-application group 83, post-application group 148), who stayed over 24 hours and complained of pain higher than Numeric Rating Scale score 4. The post-test was conducted after educating the nurses about the application of the pain management guidelines in the Electronic Medical Record. Results: This survey showed that, as the cancer pain management guidelines were applied for cancer patients with above moderate pain, the pain intensity decreased, the number of patients reaching the treatment goal score increased. Furthermore, the estimated time to reach the treatment goal decreased significantly. Conclusion: Pain intensity of the cancer patients was decreased through regular pain assessments by nurses and the medication of analgesics according to the cancer pain management guidelines. Therefore, it is necessary to develop the pain management program and to provide the physicians and nurses with intensive education about the pain management guidelines for systematic and effective pain management.

The study of stress, satisfaction and the frequency of performing of Dental hygiene students to clinical training (일부 지역 치위생과 학생의 임상실습에 대한 수행빈도, 만족도 및 스트레스에 관한 연구)

  • Park, Young-Nam;Yoon, Sung-Uk;Lee, Kyeong-hee
    • Journal of Digital Convergence
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    • v.14 no.9
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    • pp.359-367
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    • 2016
  • This study will be used as basic data to hold clinical training effective by researching and analyzing frequency, satisfaction and stress for the clinical practice of dental hygiene course students. The survey was undergone from Feb. 1, 2014 to Mar. 31 for 219 dental hygiene course juniors who had experienced clinical training in 3 year colleges located in Daejeon and Chungcheong Province. From the study, general and university hospital holds the highest satisfaction in clinical practice and dental offices in acquiring skills. Also, a significant difference is shown between the frequency and satisfaction according to clinical training sheets. The highest degree of stress is shown in dental offices for 'toothbrushing training and dental health education' and in general and university hospital for 'patient counselling'. Therefore, consideration should be made to establish the direction of education, standard criteria and evaluation method for student clinical training to raise its effectiveness.

The Case Report on Twelve Patients of Lateral Epicondylitis Treated with Muscle Contraction/Relaxation Strengthen Technique, Instrument Assisted Soft Tissue Mobilization Treatment and Acupuncture (근육 수축/이완 강화 기법과 Instrument Assisted Soft Tissue Mobilization 및 침 치료를 병행하여 치료한 주관절 외상과염 환자 치험 12예)

  • Jeong, Seung-Hyun;Kim, Chang-gon;Yun, Yeong-Ung;Ryu, Won-Hyung;Jeon, Yong-hyun;Choi, Young-jun;Chung, Jae-hyun
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.2
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    • pp.195-201
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    • 2019
  • The purpose of this study is to report the treatment effects of Korean medicine for patients with lateral epicondylitis. This study was done on 12 cases of patients with lateral epicondylitis who visited in Korean Medicine Clinic of Ganghwa-gun Public Health Care Center. We used muscle contraction/relaxation strengthen technique, Instrument assisted soft tissue mobilization (IASTM), acupuncture on patients and mesured numerical rating scale (NRS), pain disability index (PDI), and grip strength test to evaluate treatment effects. Among twelve patients, eleven cases showed decreasing in NRS and all cases showed decreasing in PDI. Ten cases showed increasing in grip strength test. Korean medical treatments including muscle contraction/relaxation strengthen technique and IASTM are thought to be one of the effective treatment for patients with lateral epicondylitis.

Incidence of Falls and Risk Factors of Falls in Inpatients (입원환자의 낙상 실태 및 위험요인 조사연구)

  • Yoon, Soo-Jin;Lee, Chun-Kyon;Jin, In-Sun;Kang, Jung-Gu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

A Case of Long Term Survival of Gastric Cancer on Trastuzumab Based Treatment (Trastuzumab으로 장기 생존한 진행성 위암 증례 1예)

  • Jihye Park;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.39-41
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    • 2015
  • We report a case of long term survival on trastuzumab based treatment. A 51-year-old man with dyspepsia received esophagogastroduodenoscopy on another hospital and was transferred for further evaluation under the impression of advanced gastric cancer, Borrmann type III, antrum, lesser curvature. After further studies in our hospital, the patient was diagnosed with advanced gastric cancer, adenocarcinoma, moderately differentiated with pancreas invasion and lymph node metastasis. Though he was recommended with chemotherapy, he refused and left for oriental herbal medicine. After 4 months, the patient was admitted through emergency room for hematemesis. Diagnosed with gastric outlet obstruction due to gastric cancer in the antrum, he underwent the placement of pyloric metal stent insertion. Immunohistochemical staining showed HER2-positive finding, and he was treated with palliative chemotherapy of trastuzumab, capecitabine, and cisplatin, 16 times during 11 months. The patient showed neutropenia after the therapy, so cisplatin was left out, and he received combination chemotherapy of trastuzumab and capecitabine, 34 times during 25 months. Response evaluation showed no remarkable change in extent of primary stomach cancer, lymph node metastasis, and regression of metastasis site, and the patient is continuing chemotherapy.

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3D printed interim immediate denture by using the occlusal plane digital transfer method of the POP BOW system in a patient planning to extract upper and lower residual teeth: a case report (상하악 전악 발거 환자에서 POP BOW 시스템의 교합평면 디지털 전이법을 이용한 3D 프린팅 임시 즉시의치의 수복 증례)

  • Park, Do-Hyun;Bae, Eun-Bin;Jung, In-Hwan;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Lee, So-Hyoun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.3
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    • pp.178-188
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    • 2022
  • Interim immediate denture is fabricated to minimize the period of edentulousness after removal of the patient's remaining teeth and before delivery of final prosthesis. In the case of using the CAD/CAM system, there is an advantage in that the manufacturing process in the clinic and laboratory can be simplified by overcoming some of the limitations of manufacturing interim immediate dentures in the traditional way. However, there are also disadvantages in that errors occur in the process of transmitting information about the patient's intermaxillary relationship to the digital network of the laboratory, resulting in unstable occlusal relationships or non-esthetic prostheses. To overcome this problem, using the simple and accurate POP BOW system's occlusal plane digital transfer method, it was possible to fabricate an esthetic and functional 3D printed interim immediate denture after removal of the remaining upper and lower anterior teeth.

Review of 2020 Major Medical Decisions (2020년 주요 의료판결 분석)

  • Park, Nohmin;Jeong, Heyseung;Park, Taeshin;Yoo, Hyunjung;Lee, Jeongmin;Cho, Woosun
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.3-48
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    • 2021
  • Among the major rulings handed down in 2020, there were cases involving anaphylaxis, which is timely as a side effect of coronavirus and flu vaccine. And as a rare case, a ruling was handed down that if medical treatment was done so unfaithfully beyond the limit of patience of ordinary people, it can be an independent illegal act and a cause of compensation for emotional distress. Also, there was a ruling in the appellate court that evaluated disability rate applying the Korean Academy of Medical Sciences Guides for the Evaluation of Permanent Impairment, not McBride system. And the supreme court made it clear that telemedicine is illegitimate. In relation to duty of explanation, it is in the process of adding detail criterion on the firm principles in the individual cases. In regard of medical records, there was a case that even when a medical record is strongly suspected to be tampered with, it is not considered to be an obstruction of proof. There were cases that resulted in different conclusion between the court of first instance and the appellate court rulings. Lastly, in the face of a growing number of cases in which doctors are sentenced to prison for malpractice, we reviewed a ruling that sentenced a doctor to prison.

주사용 요오드화 조영제 및 MRI용 가돌리늄 조영제 유해 반응에 대한 한국 임상진료지침: 개정된 임상적 합의 및 권고안(2022년 제3판)

  • Se Won Oh;So Young Park;Hwan Seok Yong;Young Hun Choi;Min Jae Cha;Tae Bum Kim;Ji Hyang Lee;Sae Hoon Kim;Jae Hyun Lee;Gyu Young Hur;Jae Yeon Hwang;Sejoong Kim;Hyo Sang Kim;Ji Young Ryu;Miyoung Choi;Chi-Hoon Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.254-264
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    • 2022
  • The Korean Society of Radiology and Medical Guidelines Committee amended the existing 2016 guidelines to publish the "Korean Clinical Practice Guidelines for Adverse Reactions to Iodide Contrast for Injection and Gadolinium Contrast for MRI: The Revised Clinical Consensus and Recommendations (2022 Third Edition)." Expert members recommended and approved by the Korean Society of Radiology, the Korean Academy of Asthma, Allergy and Clinical Immunology, and the Korean Nephrology Society participated together. According to the expert consensus or systematic literature review, the description of the autoinjector and connection line for the infection control while using contrast medium, the acute adverse reaction, and renal toxicity to iodized contrast medium were modified and added. We would like to introduce the revised contents.