• Journal of Hospice and Palliative Care
• /
• v.20 no.3
• /
• pp.167-172
• /
• 2017

End-stage liver disease (ESLD) is a terminal condition of cirrhosis which cannot be treated without liver transplantation. Thus, it is natural for patients to consider hospice/palliative care (HPC). Since the recent legislation of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life (Act No. 14013) in Korea, the practicality of this law has become an issue. The criteria for HPC should be defined with consideration to how the severity of each ESLD complication may vary by individual patients. Generally, patients qualify if they have an intractable condition despite aggressive treatment such as the hepatorenal syndrome, hepatic encephalopathy or variceal hemorrhage. However, the option of liver transplantation should be sufficiently discussed with patients and their families before making a decision on HPC. The evaluation of which ESLD patients should receive HPC should be based on a long-term doctor-patient relationship and sufficient objective data. Therefore, a multidisciplinary approach and mutual consultation among cirrhosis specialists and doctors with other expertise are essential to offer optimal and balanced treatments between liver-specific treatment and HPC. Discussed in this review are adequate criteria for HPC and special considerations for ESLD at the point of HPC.

• Journal of the Korea Convergence Society
• /
• v.13 no.2
• /
• pp.39-46
• /
• 2022

The purpose of this study is to determine the effect of a convergence approach, which applies both home environment modification applied with assistive technology and task-oriented intervention using a fall safety checklist, on the fall efficacy and activity level of stroke patients. 41 persons with stroke(21 experimental groups and 20 control groups) were divided into experimental and control groups. The experimental group was applied environmental modification and the task-oriented intervention using the fall safety checklist for 4 weeks. The control group was provided only the environmental modification. Before and after the intervention, the Korean Activity Card Sort (KACS) and the Korean Falls Efficacy Scale-Korean version (FES-K) were used for evaluation. There was no significant difference in fall efficacy and activity level change between the experimental group and the control group. Both the experimental group and the control group significantly improved the fall efficacy and activity level after the intervention. By applying the results of this study to the clinical field, it will be possible to support stroke patients to live safely and actively participate in the community.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.6
• /
• pp.1-8
• /
• 2019

Medical information is an important personal information for patients, and it must be protected. In particular, when medical personnel approach electronic medical records, authentication for enhanced security is essential. However, the existing public certificate-based certification model did not reflect the security characteristics of the electronic medical record(EMR) due to problems such as personal key management and authority delegation. In this study, we propose a fingerprint recognition-based authentication model with enhanced security to solve problems in the approach of the existing electronic medical record system. The proposed authentication model is an EMR system based on fingerprint recognition using PEMS (Private-key Escrow Management Server), which is applied with the private key commission protocol and the private key withdrawal protocol, enabling the problem of personal key management and authority delegation to be resolved at source. The performance experiment of the proposed certification model confirmed that the performance time was improved compared to the existing public certificate-based authentication, and the user's convenience was increased by recognizing fingerprints by replacing the electronic signature password.

• Sim-seong Yeon-gu
• /
• v.35 no.2
• /
• pp.85-112
• /
• 2020

How does analytical psychology help understand patients at general psychiatric clinics? It's necessary to think about how knowledge of analytical psychology can help young psychiatrists who are in training. Patients who come to us bring symptoms(problems). Symptoms can be compared to tickets to a movie theater. Symptoms accompanied by complaints of pain are not only pathological phenomena to be eliminated, but an important pathway to access the patients' inner problems. In terms of seeing the whole, the point of view in analytical psychology is to see the unconscious as well as the consciousness, even the elements the patients do not speak or know of. When determining indications and contra-indications during the initial process of treating a patient, it is more important to acknowledge the therapist's capabilities and limitations than the patient's condition or limitations The approach to complaints of the same symptoms may differ depending on whether the patient is in the first half or the second half of one's life. Analytical psychology is empirical psychology that experiences and it adheres to a phenomenological position that recognizes the phenomenon as true in itself, not logically right or wrong. The analytical psychological view of understanding mental phenomena asks the causal perspective of why the symptoms occurred. At the same time, the therapist, along with the patient, must seek answers to the question of why now and for what purpose. A therapist is a person who experiences the patient's personal development process together. In analytical psychotherapy, the therapist's attitude is more emphasized than the treatment method or technique; it is regarded as of the utmost importance. In this regard, analytical psychology is a practical and useful therapeutic tool, and is a field of study that can be widely used in actual psychiatric clinics. In addition to understanding the patient, it is also the most important discipline for the therapists, especially for the education and growth of those who want to become a treatment tool themselves.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.5 no.1
• /
• pp.9-14
• /
• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

• Journal of the Korea Convergence Society
• /
• v.3 no.4
• /
• pp.23-28
• /
• 2012

The aim of this study is to reveal the right approach and prognosis of cerebrovascular accident (CVA) by reviewing the various researches on CVAs. The reviews were done by BNBI PubMed, KMBase, RISS, and KoreaMed. Based on the articles, prevalence rate of CVA, prehospital CVA patients assessment and emergency care, and in-hospital care were analyzed. The most important scales are Cincinnati prehospital stroke scale(CPSS) and Los Angeles prehospital stroke screen(LAPSS). These two scales are the basic assessment tools for CVAs and it is necessary to perform the emergency care by way of these scales.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.17 no.1
• /
• pp.49-56
• /
• 2013

Among U-healthcare services adapting the latest IT technique and medical technique, a body-injecting device technique providing medical service to a patient who has incurable disease. But the body-injecting device technique can be easily exposed during wireless section to the third person and it can be used illegally. This paper proposes certification protocol which certifies a patient and hospital staff using random number created by certification server and a patient with hospital staff by synchronization. Specially, the proposed protocol uses security information created by information registered in certification server previously by a patient and hospital staff so that in keeps from accessing of third person who didn't get approval. And it gives more stability.

• Annual Conference of KIPS
• /
• 2020.11a
• /
• pp.784-787
• /
• 2020

폐암 환자의 생존율을 예측할 때 미국암연합회(AJCC)의 TNM병기 분류체계에 의해 진단되는 최종병기를 많이 사용한다. 최종병기는 폐암환자의 임상데이터 중 하나로 종양의 위치, 크기, 전이정도를 고려하여 환자의 폐암 상태를 판별하는 정보이다. 최종병기는 개략적인 환자의 상황을 설명하는 데 효과적이지만, 보다 구체적인 생존분석을 위해서는 임상데이터 뿐만 아니라 PET/CT와 같은 영상 데이터를 함께 분석해야 한다. 이 논문에서는 데이터 과학적 접근을 통해 폐암환자의 임상데이터, CT영상과 PET영상 등 다양한 종류의 데이터를 함께 활용하는 생존분석기법을 검토한다. 실험을 통해 다중 모드 데이터를 활용하는 생존분석을 위해 비선형모델 개발과 Feature임베딩 기법 고도화가 필요함을 확인하였다.

• Journal of dental hygiene science
• /
• v.10 no.1
• /
• pp.55-61
• /
• 2010

The main purpose of this study was to identify the service quality of some dental clinics located in Gwangju and find an association between service quality and patient's intention to re-visit the same dental clinic. The search objects were 197 patients from five dental clinics, and data collected by self-administered questionnaire which was composed general characteristics, characteristics relating to visit of clinics, quality of service, patients satisfaction and intentions to re-visit. The used statistical analysis to find the association between quality of service and intention to re-visit was multiple regression analysis. This study looked at relations between quality of dental service, service satisfaction and intentions to visit again, and found that quality of service including six service areas had a statistically significant positive correlations with satisfaction and intentions of re-visit. When this study conducted a multiple regression analysis to identify variables that influence intentions of re-visit, it found that patients revisited the dental clinic only when quality of service was included. In conclusion, quality of service evaluated by patients influenced on their intention of re-visit and especially. Therefore, this study concludes that improvement in satisfaction and intentions of re-visit relies on Accessibility, that is, providing of medical information, consultant telephone, how delivery the dental medical system is. Service quality of dental institutes measured by SERVQUAL model and intention to re-visit.

• Journal of Chest Surgery
• /
• v.35 no.7
• /
• pp.553-555
• /
• 2002

Transabdominal approach in redo coronary artery bypass grafting(CABG) may avoid the risk related to repeat sternotomy. Redo CABG using this approach can be performed safely in selected cases. We report a case of redo off-pump CABG through a transabdominal approach in a 59-year-old woman with recurrent unstable angina after a previous CABG. Through a curvilinear epigastric incision, right gastroepiploic artery(RGEA) was harvested as a graft, and the RGEA-to-right coronary artery anastomosis was performed on the beating heart. A 1-day postoperative angiographic study showed the patent RGEA graft, and she was discharged on postoperative 4th day without any complication.