• Title/Summary/Keyword: 초기진료

Search Result 72, Processing Time 0.022 seconds

The Epidemiologic and Clinical Study of Pulmonary Tuberculosis - Among Students at One Women's University for Recent 10 Years - (일개 여자대학교 학생의 최근 10년간 폐결핵 동태 및 임상경과에 관한 고찰)

  • Choi, Hee-Jung;Hong, Young-Sun;Oh, Ji-Yong;Cheon, Seon-Hee;Kim, Kyung-Ja;Kim, Man-Ae;Min, Hong-Ki;Choi, Sam-Sub;Lee, Kee-Young
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.4
    • /
    • pp.465-473
    • /
    • 1995
  • Background: The prevalence of pulmonary tuberculosis has decreased progressively after the control of the tuberculosis began as national control. But as diabetes, malignancy, immunodeficiency disease recently tend to be increased, the tuberculosis become to the important national health problem. So, this study was designed to observe the state and the change of the prevalence and the clinical status of pulmonary tuberculosis for recent 10 years at one women's university. Method: We retrospectively investigated the epidemiology and the clinical status of 612 patients who were registered at the Ewha Womans University Health Center by analyzing records from 1983 to 1992. Results: 1) The prevalence rate had been steadily decreased from 0.63% in 1983 to 0.11 % in 1992. The prevalence of freshman and the incidence rate according to the entrance year while in the university significantly decreased since 1989. 2) In classifying by registered source, 45.6% of students were detected by annual periodical health examination, 34.5% by entrance physical examination, 12.0% by hospital, 5.4% by health center clinic, 2.5% by reentrance physical examination, sequentially. 3) The students with past history of tuberculosis were 70(11.4%) and 61(10%) suffered from pulmonary tuberculosis. The patients with family history of tuberculosis were 142(23.3%). 4) There were 530(86.6%) with minimal disease, 79(12.9%) with moderate and only 3(0.5%) with far advanced, when classified by the severity of disease. 5) The initial symptoms were mild breathing difficulty in 30.1%, sweating in 14.9%, fatigue in 14.3%, febrile sense in 11.7%, hemoptysis in 8.2%, sequentially. 6) The duration of treatment was $10.6{\pm}3.6$ months in mild group, $14.9{\pm}5.2$ months in the moderate group(P<0.05). 7) The side reactions of the drug were GI trouble in 7.2%, hepatitis in 1.8%, skin rash in 0.8% and streptomycin side in used patients in 9.1%. Conclusion: The prevalence of pulmonary tuberculosis among the students in one women's university was significantly lower than that of university students and 20-24 year-old age group announced in tuberculosis survey on a national scale, and significantly decreased since 1989. The treatment effect was desirable in student's group managed by university health center.

  • PDF

A component based framework for service development of ubiquitous healthcare (유비쿼터스 서비스 개발을 위한 컴포넌트 기반의 서비스 개발 프레임워크)

  • Yang, Won-Seop;Lee, Geon-Myeong;Kim, Won-Jae;Yun, Seok-Jung
    • Proceedings of the Korean Institute of Intelligent Systems Conference
    • /
    • 2007.04a
    • /
    • pp.324-328
    • /
    • 2007
  • 유비궈터스 헬스케어는 단일화된 서비스가 아니라 다양한 기술들이 복합적으로 결합되어 운용되는 서비스이다. 따라서 서비스의 형태가 고정적이지 않고 매우 다양하게 나타난다. 하지만 실제로 차이가 발생하는 부분은 서비스의 구현에 관한 세부적 내용에서 나타나고, 서비스 운용을 위한 기본 구성요소에 있어서는 큰 차이가 없이 유사한 형태를 가진다. 그 결과 유비쿼터스 헬스케어 서비스 개발 과정에서는 실제 서비스의 구현 외의 통신과 데이터베이스의 이용, 메시지 전달과 같은 중복되는 항목에 대한 고려가 매번 이루어져야 한다. 이것은 개발 과정에 있어 불필요한 비용의 증가를 불러온다. 본 논문에서는 이와 같은 불필요한 비용을 감소시키며 서비스의 개발과 운용이 가능한 유비쿼터스 헬스케어 서비스의 제공을 위한 아키텍처와 서비스 개발을 위한 프레임워크를 제안한다. 제안하는 서비스 제공 아키덱처는 크게 이용자 단말, 유비궈터스 헬스케어 서비스 센터, 외부 기관으로 구성된다. 서비스 개발 프레임워크는 서버와 클라이언트 프레임워크로 구분된다. 서비스 개발 프레임워크는 서비스를 제공하는 서버에서 필요한 유비쿼터스 헬스케어 서비스의 공통 구성요소를 가진다. 서비스의 개발을 위해 우선 프로세스에 대한 정의를 수행하고, 정의된 내용에 따라 필요한 코드 템플릿을 결합하여 서비스의 초기 형태를 만들어낸다. 여기에 각 서비스가 필요로 하는 세부 사항을 작성하는 것으로 서비스의 개발을 수행하게 된다. 제안된 서비스 제공 아키텍처와 서비스 개발 프레임워크를 실제 적용해보기 위해 전림선비대증 환자 진료를 위한 시스템을 설계하고 구현하였다.JSHOP2 계획수립기내에 구현하였다. 계획 실행 방법으로는 주어진 강건한 계획에 대하여 행위들이 직접 실행하수 있도록 한다.며 용량에 의존하는 양상을 보였다. $H_2O_2$에 의해 유발(誘發)된 DNA의 손상은 catalase와 deferoxamine에 의해 억제되었지만 DPPD는 억제시키지 못했다. 배기음(排氣飮)은 $H_2O_2$에 의해 유발(誘發)된 ATP의 소실을 회복시켰다. 이러한 실험결과 $H_2O_2$에 의해 유발(誘發)된 세포(細胞)의 손상(損傷)은 지질(脂質)의 과산화(過酸化)와는 다른 독립적인 기전에 의해 일어남을 나타낸다. 결론 : 이러한 결과들로 볼 때 Caco-2 세포(細胞)에서 배기음(排氣飮)이 항산화작용(亢酸化作用)보다는 다른 기전을 통하여 Caco-2 세포안에서 산화제(酸化劑)에 의해 유발(誘發)된 세포(細胞)의 사망(死亡)와 DNA의 손상(損傷)을 방지할 수 있다는 것을 가리킨다. 따라서 본 연구(硏究)는 배기음(排氣飮)이 반응성산소기(反應性酸素基)에 의해 매개된 인체(人體) 위장관질환(胃腸管疾患)의 치료(治療)에 사용할 수 있을 가능성(可能性)이 있음을 제시하고 있다.에 이를 이용하여 유가배양시 기질을 공급하는 공정변수로 사용하였다 [8]. 생물학적인 폐수처리장치인 활성 슬러지법에서 미생물의 활성을 측정하는 방법은 아직 그다지 개발되어있지 않다. 본 연구에서는 슬러지의 주 구성원이 미생물인 점에 착안하여 침전시 슬러지층과 상등액의 온도차를 측정하여 대사열량의 발생량을 측정하고 슬러지의 활성을 측정할 수 있는 방법을

  • PDF

Development of MRI Simulator Early Diagnosis Program for Self Learning (자가 학습을 위한 MRI Simulator 초기 검사 프로그램 개발)

  • Jeong, Cheon-Soo;Kim, Chong-Yeal
    • The Journal of the Korea Contents Association
    • /
    • v.15 no.9
    • /
    • pp.403-410
    • /
    • 2015
  • Since 1970, MRI has greatly been developing in terms of strength of magnetic field, the number of receipt channels, and short time of examination. With the development of digital systems and wireless network, hospitals have also acquired, saved, and managed digital images taken by various kinds of medical imaging equipment. However, domestic universities fail to provide practice training course independently thanks to expensive practice equipment and high maintenance cost, and rely on clinical training. Therefore, this study developed a MR patient diagnosis program based on Windows PC to help out students before their working in clinical filed. The designed Relational Database of MRI Simulator is made up of seven tables according to functions and data characteristics. Regarding the designed patient information, each stepwise function was classified by the patient registration method in clinical field. In addition, on the assumption of the basic information for diagnosis, each setting and content were classified. The menu by execution step was arrayed on the left side for easy view. For patient registration, a patient's name, gender, unique ID, birth date, weight, and other types of basic information were entered, and the patient's posture and diagnosis direction were set up. In addition, the body regions for diagnosis and Pulse Sequence were listed for selection. Also, Protocol name and other additional factors were allowed to be entered. The final window was designed to check diagnosis images, patient information, and diagnosis conditions. By learning how to enter patient information and change diagnosis conditions in this program, users will be able to understand more theories and terms learned in practice and thereby to shorten their learning time in actual clinical work.

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center (외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험)

  • Kim, Hyung Won;Hong, Tae Hwa;Lee, Seung Hwan;Jung, Myung Jae;Lee, Jae Gil
    • Journal of Trauma and Injury
    • /
    • v.28 no.4
    • /
    • pp.241-247
    • /
    • 2015
  • Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

  • PDF

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
    • /
    • v.20 no.2
    • /
    • pp.81-92
    • /
    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN A MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA (다발성 손상을 가진 정신지체 환자에서 치료 우선순위로 구강출혈의 조절)

  • Oh, Ji-Hyeon;Kim, Ji-Hun;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.12 no.1
    • /
    • pp.20-26
    • /
    • 2016
  • Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

The impacts of high speed train on the regional economy of Korea (고속철도(KTX) 개통이 지역경제에 미치는 영향 분석과 시사점)

  • Park, Mi Suk;Kim, Yongku
    • The Korean Journal of Applied Statistics
    • /
    • v.29 no.1
    • /
    • pp.13-25
    • /
    • 2016
  • High-speed railway (Korea Train Express) has had a deep impact on the regional economy of Korea. Current high-speed rail research is mostly theoretical, there is a lack of quantitative research using a precise algorithm to study the effect of high-speed railway on the regional economy. This paper analyses the influence of high-speed rail on the regional economy, with a focus on the Daegu area. Quantitative analysis using department store indexes and regional medical records is performed to calculate the economic influence of high-speed rail. The result shows that high-speed railway effects the regional economy though regional consumption growth and medical care trends.

The Assessment Tools in Palliative Medicine (완화 의학에서의 평가도구)

  • Gwak, Jung-Im;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
    • /
    • v.12 no.4
    • /
    • pp.177-193
    • /
    • 2009
  • The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

  • PDF

Melatonin for Treatment of Delirium in Hospitalized Patients : Retrospective Trial (입원 환자의 섬망 치료에서 멜라토닌의 효과에 관한 후향적 연구)

  • Yang, Jung Woo;Kim, Jong Woo;Kang, Won Sub;Lee, Sang Min;Kim, Young Jong;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.26 no.2
    • /
    • pp.112-118
    • /
    • 2018
  • Objectives : Delirium is one of the most common mental illnesses that can affect cognitive function. Melatonin has been shown to be effective in the treatment of insomnia, and recent studies have shown a protective effect to prevent delirium. This study was conducted to investigate the efficacy of melatonin in delirium patients. Methods : All patients were referred to psychiatric department for insomnia and symptoms of delirium, and were diagnosed delirium by the DSM-5 diagnostic criteria. We compared base line severity of delirium with K-DRS-R-98-R (Korean version of Delirium Rating Scale revised 98) and after taking 2mg of melatonin, retrospectively. The side effects were also identified by referring to the medical records. Results : A total 21 patients had taken melatonin for insomnia and delirious symptoms. The K-DRS-R-98 scores were decreased from $15.24{\pm}2.64$ before treatment to $6.57{\pm}5.42$ after treatment. And CGI-S scores were also decreased from $4.14{\pm}0.48$ before treatment to $2.81{\pm}0.93$ after treatment (p<0.05). Conclusions : This study illustrates the possibility of melatonin as an effective treatment option for delirious symptoms such as disorientation, motor agitation, lability of affect and hallucinations as well as insomnia, with less concerns of drug side effect. Further study with a larger sample and prospective design will be required to confirm these results.

A Study on Restriction of Access to Medical Institutions and Discrimination on Human Rights of Persons with Disabilities Not Wearing Masks to Prevent Healthcare-Associated Infections (의료관련감염 예방을 위한 마스크 미착용 장애인의 의료기관 출입제한과 인권차별 결정에 대한 검토)

  • Moon, Sang Hyuk;Kim, Je Sun
    • The Korean Society of Law and Medicine
    • /
    • v.24 no.1
    • /
    • pp.67-98
    • /
    • 2023
  • In the early stages of the COVID-19 pandemic, Korea took the lead in implementing "social distancing" policies more strongly than other countries. In addition to making it mandatory to wear a mask according to the policy, all patients using medical institutions are tested for COVID-19 to prevent Healthcare-Associated Infections, and only those patients who test negative have been regulated to receive face-to-face medical treatment. In this process, situations such as the disabled, who have difficulty wearing masks, were not taken into account, and emergency patients did not receive timely treatment or surgery from medical personnel. In response, the National Human Rights Commission of Korea has decided that forcing everyone to wear a mask and restricting access to medical institutions constitutes discrimination against the disabled. Therefore, the purposes this study has that, the first is to review cases of human rights discrimination against persons with disabilities due to measures to prevent the transmission of infectious diseases that did not consider the characteristics of persons with disabilities in the COVID-19 situation and issues regarding the decisions of the National Human Rights Commission of Korea, the second is to find a reasonable plan and the need for measures to prevent refusal of treatment by medical institutions for the disabled who have difficulty wearing masks.