• Title/Summary/Keyword: 초기진료

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Development of Hospice Oriented Medical Record (HOMR) for Cancer Patients (호스피스 암 환자를 위한 의무기록지의 개발)

  • Seng, Jeong-Won;Hong, Sung-Moon;Kim, Si-Wan;Kim, Jeong-A;Park, Joon-Chul;Kim, Su-Hyun;Seo, Min-Jeong;Her, Sin-Hoe;Kim, Hye-Won;Hong, Myung-Ho;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.49-63
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    • 2004
  • Purpose: The Hospice Oriented Medical Record (HOMR) was developed for assessing the pain and symptoms of terminal cancer patients. Methods and Results: The HOMR consists of an instruction for users and 2 assessment pages which include the graph showing vital signs (temperature, blood pressure, pulse, respiration rate and pain score), current problem lists, performance status, laboratory data, pain characteristics and management, sedation score, associated symptoms and drug side effects, etc. Pilot study was performed in the inpatient Hospice Care Unit in Guro Hospital, Korea University Medical Center. Because an one-week progress data was recorded in HOMR as a flow sheet, the patient's condition and pain control status could be seen at a glance. Conclusion: The HOMR is useful for assessing the terminal cancer patients because it is simple and convenient to use. Further research is needed before it can be universally used in the clinical settings.

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A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients (야뇨증 치료반응 예측에 관계하는 평가지표)

  • Lee, Kang-Gyoon;Lee, Hyun-Jung;Lim, Yun-Ju;Kwon, Duck-Geun;Kim, Eun-Jin;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.272-279
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    • 2007
  • Purpose : We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. Methods : Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none(<50%), partial(50-90%) and complete(90%) response groups. We also compared the 'initial responders' who showed improvement(${\ge}50%$) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. Results : Parameters mentioned above showed no significant relation to the treatment out-come. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3% (2/151), partial in 29.6% (47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73) (P<0.05). Conclusion : We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

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Development of the Disaster Medical Manual in Korea (국가재난의료매뉴얼의 개발)

  • Wang, Soon-Joo
    • Journal of Korean Society of Disaster and Security
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    • v.9 no.1
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    • pp.39-45
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    • 2016
  • The disasters in Korea, such as the Sewol Ferry Ship sinking disaster has had problems related to the medical response system, with the problems of emergency medical support team in the site, the cooperation between medical staff and fire department officer at disaster site, field medical support and hospital acceptance of the wounded in trouble, the lack of specific systematic medical response manual. Therefore, from May 2014, when the disaster emergency information center in Central Emergency Medical Center starts, collection, modification and education of scattered preexisting disaster emergency medical manual had appeared as important issues. So, it was necessary to develop the early medical response system to disaster. The correction planning of disaster emergency medical response system by Central Emergency Medical Center included quick response system with the fast medical team operation, but the practical application was not enough. So the researcher and his team developed the first Korean disaster emergency medical response manual and the process of development was documented and arranged with the application by education and training.

An 8-month-old Male Infant with High Grade Vesicoureteral Reflux who Developed Incomplete Kawasaki disease after Recurrent Pyelonephritis (급성 신우신염이 재발한 후 불완전 가와사끼병이 발생한 고도의 방광요관역류가 있는 8개월 남아)

  • Jung, Su Jin;Park, Sung Eun;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.42-46
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    • 2014
  • Kawasaki disease (KD) is a systemic vasculitis that can affect many organ systems. Renal manifestations include pyuria, hematuria, proteinuria, tubulointerstitial nephritis, acute renal failure, hemolytic uremic syndrome, or renal scarring. Although its precise pathogenesis remains unknown, it is considered an autoimmune disease. In the literature, it has been reported that KD may develop in conjunction with urinary tract infections. However, many of these previous studies did not use imaging methods such as renal sonograms, dimercaptosuccinic acid renal scans, and voiding urethrocystograms. We report a case of an 8-month old male infant with high grade vesicoureteral reflux, who developed incomplete KD after recurrent pyelonephritis. Acute pyelonephritis can be an early manifestation of KD. Such cases require the evaluation of urinary tract anomalies according to the guidelines for the management of urinary tract infections.

The Effect of Timing of Primary Surgery on Outcomes of Lumbar Herniated Intervertebral Disc (요추 추간판탈출증 환자의 초기 수술시점이 진료결과에 미치는 영향)

  • Choi, Bo-Ram;Ji, Young-Geon;Shin, Dong-Ah;Om, Young-Jin;Rhie, Dong-Mo;Kang, Hyung-Gon
    • The Korean Journal of Health Service Management
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    • v.8 no.1
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    • pp.151-164
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    • 2014
  • This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

Factors Influencing Intent to Revisit of Health Screening Center Visitors (건강검진센터 이용자의 재이용 의도에 미치는 영향요인)

  • Bang, Eun-Pil;Kim, Jeong-Hee
    • Journal of Digital Convergence
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    • v.18 no.1
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    • pp.147-157
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    • 2020
  • The purpose of this study was to investigate the factors influencing the intent to revisit among health screening center customers. The subjects were 195 customers of a health screening center. The intent to revisit was positively correlated with customer satisfaction and word-mouth communication. Multiple regressions showed that customer satisfaction and perceived health status explained 29% of the variance of the intent to revisit. In order to increase the intent to revisit, hospital and nursing managers should strive to improve customer satisfaction. In particular, strategies to arrange explanation of the result consultations, individual health management tailored to customers' needs, and customers-relationship management for continuing relations with the customer should be needed. In addition, it will be needed to expand the roles of nurses who are working in the health screening center from simple heath check or customer reception to active health education and continuous health screening plan after initial one.

Genetic association study of single nucleotide polymorphism in dentistry (단일염기다형성을 이용한 치과 질환 유전체 연구)

  • Kim, Jee-Hwan;Lee, Jae-Hoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.4
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    • pp.341-345
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    • 2011
  • Genetic association study has been progressed in medicine along with advance in genetic technology. It focused on the individual differences in genotype due to errors occurring during DNA duplication, which can cause vulnerability to specific diseases. Polymorphism defines the varieties in phenotype due to those genetic variations. Polymorphism due to change in one DNA base sequence is called as a Single Nucleotide Polymorphism. In the near future, the evaluation of relative risk to specific disease according to SNP will be essential part of fundamental of medicine for the diagnosis, treatment and prevention. Dental caries and periodontal diseases has been first subject to genetic association study in dentistry and broaden out to other areas like bone formation and resorption. This article presents the current state of genetic association study and its application to dentistry.

The effect of Smart Care ubiquitous health service on hypertension management (고혈압관리에서의 스마트케어 서비스의 효과)

  • Chung, Young-Soon;Moon, Mikyung;Lee, Chang Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1213-1220
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    • 2013
  • The purpose of this study was to identify the effect of the Smart Care ubiquitous healthcare service on hypertension management. Fifty one patients with inadequately controlled blood pressure (Systolic Blood Pressure ${\geq}$ 140 mmHg despite prescribed antihypertensive medication) from 4 local clinics participated in this study. Remote biometric monitoring and healthcare consultation via videophone was provided to the participants during 24 week - Smart Care service. The average number of blood pressure monitoring and the average day of remote consult using Smart Care Service system was 121 and 14.8 per participant. As a result of analyzing change in blood pressure during 24 weeks, there was a significant difference in blood pressure between baseline and 24 weeks. Systolic blood pressures of 86.3% participants were dropped within a normal range at 24 week. Smart Care u-health service could be effective in reducing blood pressure.

Evaluation of the Underlying Etiology and Long-Term Prognostic Factors in Neonatal Cholestasis (신생아 담즙정체증의 원인질환 및 장기추적 예후인자에 관한 고찰)

  • Kim, Kyung-Mo;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.46-58
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    • 1999
  • Purpose: The aim of the present study was to evaluate the long-term clinical profile including the underlying etioligy and the prognostic factors of the neonatal cholestasis. Method: We studied the 190 infants presented with neonatal cholestasis for the last 12 years (from 1981 to 1992). The underlying causes, clinical findings and long-term outcomes were evaluated. And the prognostic factors were also analyzed. Result: Underlying disease were neonatal hepatitis in 101 (idiopathic in 77 and infectious in 24), intrahepatic bile duct paucity in 5, biliary atresia in 79, choledochal cyst in 5. Metabolic disease was not observed in this study. The important clinical problems during follow-up were persistent high fever, gastrointestinal bleeding, hepatic encephalopathy and ascites. The main causes of the death were hepatic encephalopathy and gastrointestinal bleeding. While three fourth of infants with idiopathic and infectious neonatal hepatitis recovered usually within a year, five-year survival rate for biliary atresia was just 40%, the mortality observed usually within the first year after Kasai operation and prognostic factor was the time of operation. Underlying disease was the most important prognostic factor of neonatal cholestasis. Conclusion: This study showed that most common causes of neonatal cholestasis were biliary atresia and idiopathic neonatal hepatitis, infectious neonatal hepatitis, choledochal cyst and Alagille syndrome, but few neonatal cholestasis of genetic or metabolic liver disease was observed. The most important long-term prognostic factor of neonatal cholestasis was the underlying disease.

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