• Title/Summary/Keyword: 환자의 접근

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의과대학생의 미래와 진로지도

  • Yang, Eun-Bae
    • Korean Medical Education Review
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    • v.8 no.1
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    • pp.35-54
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    • 2006
  • 의사에게 있어 자신의 적성과 능력에 부합하는 세부 전공을 선택하는 것은 자신의 자아실현뿐만 아니라 환자들에게도 중요한 의미를 갖는다. 이것은 의과대학생들의 전공 선택을 위해 의과대학 재학 중에 이루어지는 진로개발의 중요성을 시사한다. 이 글은 의과대학생 개개인의 적성과 소질에 따른 전공 선택을 어떻게 지도할 수 있는지 단계별 진로지도 전략에 대해 고찰하였다. 전공 선택 지도의 첫 번째 단계는 자기평가이다. 자기평가는 자신의 적성과 능력에 맞는 전공을 선택하기 위해 스스로에 대한 정보를 모으고 이해하는 과정이다. 두 번째는 전공탐색 단계이다. 이 단계는 자신의 적성과 능력에 부합할 가능성이 높은 전공과목에 대한 정보를 수집하는 것이다. 세 번째는 전공 선택 단계이다. 이 과정은 학생 스스로에 대한 자기평가 결과 및 전공에 대한 탐색 결과에 기초하여 자신이 어떤 분야에 더 적합한가에 대한 의사결정을 하는 과정이다. 전공 선택을 위한 접근 방법의 마지막은 전공 영역의 수련을 위해서 자신이 결정한 전공 선택을 이행하는 단계이다. 이 단계에서는 자신이 선택한 전공영역, 그리고 전공의 수련교육과정을 제공하는 교육기관에 응시원서를 제출하고, 면접을 실시하는 과정이 포함된다. 의과대학생들이 자신의 적성과 소질에 따른 전공 선택과 의과대학생 개개인의 선택의 문제를 넘어 의료 인력의 수급, 의료서비스의 질적인 수준과 밀접하게 관련되어 있다. 그러므로 의과대학은 대학의 책무성 수행차원에서 학생들의 가치관 확립과 진로지도를 위한 체계적인 학생 진로지도 프로그램을 개발하고 학생들을 적극적으로 지원해야 한다.

A Facial Nerve Palsy Cases Managed by Yinyang Balancing Appliance (YBA) of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System (턱관절자세음양교정술(FCST)의 음양균형장치를 활용한 구안와사 증례보고)

  • Kim, Yun Sang
    • Journal of TMJ Balancing Medicine
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    • v.6 no.1
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    • pp.5-10
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    • 2016
  • Therapeutic effect of temporomandibular joint postural training by functional cerebrospinal therapy (FCST) for the balance of the meridian and neurologic system was observed in a facial palsy case. An idiopathic facial palsy case of House-Brackmann grade V was managed with FCST, combined with acupuncture and postural training of the cervical and pelvic structures. Clinical outcome measurement was performed by House-Brackmann grade and Yanagihara's scale. The patient showed positive changes in the degree of palsy and subjective symptoms within one month. Further research on the effect of FCST is expected.

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Manual Therapy for Patient with Spasmodic Torticollis - Case Study (연축성 사경환자에 대한 도수 치료적 접근 - 사례연구)

  • Kim, Dong-Ya;Shin, Eui-Ju;Jeon, Jae-Guk
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.79-83
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    • 2013
  • Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

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Esophageal Stent Insertion at the Esophagogastrostomy Site Stenosis - Report of 3 cases - (식도 재건술후 발생한 식도-위 문합부 협착의 식도스텐트를 이용한 치험 -3례 -)

  • 정성철;배윤숙;유환국;정승혁;이정호;김병열;이명준
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.55-58
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    • 2003
  • Although postanastomosis of esophageal reconstruction is rare but it is a very unwelcome complication. Previously, the problem was solved by balloon dilatation, reoperation, and feeding jejunostomy. However, balloon dilatation is not effective because of high recurrence rate, reoperation is difficult due to its operative approachableness and also jejunostomy is inconvenient for patients. Therefore, we inserted esophageal stent as a method of relieving postanastomosis stenosis, From Jan, 2001 to Dec, 2001, there were three patients with postanastomosis stenosis, who received esophageal stent insertion, one had case is benign esophageal stenosis, two had esophageal carcinoma. We followed up them over 12 months after inserting the stent, Dysphagia was improved, so we report that the clinical performance was satisfactory

A Case of Metastatic Brain Cancer from Squamous Cell Carcinoma of the Tonsil (편도 편평세포암종의 뇌전이 1례)

  • Chu Hyung-Ro
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.232-234
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    • 1999
  • Distant metastases of head and neck cancer have become an increasingly common cause of death as local and regional control has improved. The most frequent metastatic sites of head and neck cancer are the lung, liver, bone and kidney; but metastases to the gastrointestinal tract, brain and heart have also been reported. We report a recent case of a 37-year-old male patient with squamous cell carcinoma of the tonsil who had undergone composite operation with left radical neck dissection and postoperative radiotherapy. The patient presented three years later, cachexic and complaining of severe deep seated headache. Radiologic evaluation revealed a cystic mass with peripheral enhancement in left temporal lobe that was proven to be metastatic cancer by burrhole exploration. However, in spite of various modalities, the patient expired.

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Quality of Life in Cancer Patients;Grounded Theory (암 환자 삶의 질에 대한 근거이론적 접근)

  • Lee, Eun-Hyun;Song, Yeoung-Suk;Chun, Mi-Son;Oh, Ka-Sil;Lee, Won-Hee;Lee, Young-Hee
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.71-81
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    • 2004
  • The purpose of the study was to understand and explore the quality of life in cancer patients in the context of a Korean culture and society. Grounded theory method guided the data collection and analysis. A total of 10 cancer patients was selected by a theoretical sampling. The data were collected by an open question. All interviews were audio taped and transcribed verbatim. Constant comparison analysis was employed to analyze the data. As the results, eighty-five concepts and twelve categories were emerged, and "keeping well-being status" identified as a core category. Quality of life related categories derived from this study will academically contribute to the understanding and expansion of theoretical bases for quality of life of Korean cancer patients and to the contexts for the development of measurement of quality of life. Furthermore, they will function as the foundation of a intervention development for quality of life.

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6 Case Reports on Parkinson's Disease Patients Treated by Sasang Constitutional Medicine: Focused on Stance and Gait Analysis (사상의학적(四象醫學的)으로 접근한 파킨슨 증후군 환자 치험 6례 : 균형 및 보행분석을 중심으로)

  • Koh, Young-Mee;Kwak, Jin-Young;Park, Jung-Hwan;Ahn, Taek-Won
    • Journal of Sasang Constitutional Medicine
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    • v.29 no.2
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    • pp.182-201
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    • 2017
  • Objectives Gait disorders are incapacitating symptoms of Parkinson's disease(PD). Here, we report improvements of patients diagnosed with PD treated by Sasang Constitutional Medicine, focused on gait and balance analysis. Methods The patients diagnosed with PD were treated on the basis of Sasang Constitutional Medicine, and their stance and gait status were analyzed by zebris Medical GmbH. To evaluate other general symptoms related with PD, GAS scale, NRS scale, H&Y scale and UPDRS were used. Results Stride length, velocity, stance phase, lateral symmetry were improved in all 6 patients. Other symptoms related to Parkinson's disease were reduced, along with the improvements in GAS scale, NRS scale, H&Y scale and UPDRS score. Conclusion This case study showed Sasang Constitutional Medicine is effective in various symptoms of Parkinson's disease. Especially in regard to the stance and gait status, the improvements were assessed accurately with Gait analysis.

DENTAL TREATMENT OF THE PATIENT WITH ACHONDROPLASIA UNDER GENERAL ANESTHESIA (연골무형성증 환아의 전신마취하 치과치료)

  • Jeon, Eun-Kyung;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.119-122
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    • 2011
  • Achondroplasia is one of the most common types of dwarfism and is inherited as an autosomal dominant trait. Clinical features of achondroplasia include disproportionate short stature with normal trunk length, shortening of the extremities, bowing of the lower extremities, short stubby trident hands, spinal stenosis and lumbar lordosis. Characteristic craniofacial features include macrocephaly, prominent forehead, depressed nasal bridge, maxillary hypoplasia, otolaryngeal system dysfunction, and foramen magnum stenosis. These characteristics may lead to number of complications including hydrocephalus, apnea, upper-airway obstruction, otitis media, sinusitis and dental malocclusion. Apart from these features, the affected children have good general health and normal intelligence. Dentists should be aware of the clinical characteristics of achondroplasia and the complications that may arise as a result of this disorder. This case report is to present dental treatment of a patient with achondroplasia under general anesthesia and discuss special considerations.

An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance (우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향)

  • Lee, Jong Hyuk;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.124-130
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    • 2018
  • Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

교정적 치료

  • Yang, Won-Sik
    • The Journal of the Korean dental association
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    • v.20 no.9 s.160
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    • pp.753-758
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    • 1982
  • 선천이상 중에서도 순열과 구개열은 특상한 성질의 것으로서 안모의 변형, 발음장애, 신체타부와의 관계기형, 이비인후과질환을 병발하기 쉽고, 호흡기, 소화기 질환에 이환되기 쉬으며 환자는 정신적, 사회적으로도 매우 불리한 위치에 놓여 있는 신체장애자로, Fogh-Anderson은 순열과 구개열은 열성반성유전(recessive sexlinked heredity)을 한다고 보고했다. 그러나 구개열은 유전적추적이 불가능하기 때문에 그 발생원인으로 물리적원인을 우선적으로 들고있다. 발생기전은 태생 8~12조경의 제2차구개형성기에 어떤 이유로 양측의 구개돌기(palatine process)와 비중격이 분리되있는 채로 있든가, 접근해서도 유합되지 않고 있든가의 조해요인으로 태아의 모태내에 있어서의 자세, 특히 흉부에 의한 하악골압박에 의해 발생하는 소악증(micromandible), 설하수(glossoptosis)를 동반하는 Pierr Robin syndrome, 태생 8~10조경까지의 혀의 만기정유, 지, 제대의 원시구강내로의 미입등을 들수있다. 순열 및 구개열환자의 치료에 있어서 종래에는 전과정이 외과의사에게만 맡겨졌었으나, 구순, 비부의 추형등의 문제, 특징적으로 발생되는 하악의 열성장, 이별궁이 왜형, 발음장애등의 문제점해결을 위하여 필연적으로 이에 관계있는 명기다른 전문분야의 전문의가 시술에 임하게되는 multidiscipline approach로서 종합진단, 장기치료계획의 입안, 전문적 의견의 교환을 통해서 치료시기, 치료순서의 결정으로 성공적인 순열및 구개열의 치료목표를 달성하리라고 생각한다.

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