• Title/Summary/Keyword: Follow-Up System

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Developing a Computerized Reminder System and Evaluating the Effects on the Improvemtent of Cancer Screening (지역사회 주민의 정기적 암검진 수검율 향상을 위한 정보시스템 구축 및 효과평가)

  • 정인숙;천동환;김일;배은숙;최은옥
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.400-411
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    • 2004
  • Purpose: This study was aimed to develop a computerized reminder system and evaluate it's effect in terms of percent age change of screening, and satisfaction. Method: It was conducted through 6 phases: Analyzing the job and defining the basic input data, developing the information system, collecting and inputting data, testing the system, working with the system, and evaluating it's effect. Participants were 787 people (female 30-69 years, and males 40-49 years) in 2 dong of Suyoung gu, Busan, who haven't had cancer screening for the stomach, breast, or cervix since Dec. 2000. There were three experimental groups: a letter; calling and calling after the letter reminder, and a non-equivalent control group. To determine whether services were obtained, a telephone survey was done after two months of follow-up. Result: A cancer screening information system with five DB modules was developed. Overall compliance with screening was not statistically significantly changedbefore and after applying computerized reminders for all three screening sites. Only 16% were satisfied with the reminder. Conclusion: This data didn't show that a reminder effort was effective of screening. However, because the evaluation interval was too short to find a difference in screening rate, we recommend additional longer prospective follow up studies.

LONG TERM FOLLOW-UP OF MULTIPLE ODONTOGENIC KERATOCYSTS ASSOCIATED WITH BASAL CELL NEVUS SYNDROME: A CASE REPORT (기저세포모반 증후군과 관련된 다발성 낭종의 장기 치료결과: 증례보고)

  • Lee, Eun-Young;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.81-85
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    • 2010
  • Multiple jaw cysts are one of the most constant features of the basal cell nevus syndrome. Basal cell nevus syndrome is inherited as an autosomal dominant trait with variable expressiveness. This syndrome comprises a number of abnormalities such as multiple nevoid basal cell carcinomas of the skin, skeletal abnormalities as bifid rib and fusion of vertebrae, central nervous system abnormalities as mental retardation, eye abnormalities with multiple jaw cysts. The odontogenic keratocysts in patients with this syndrome are often associated with the crowns of unerupted teeth and huge size; on radiographs they may mimic dentigerous cysts. The most important feature of the cyst is its extraordinary recurrence rate. Since recurrence may be long delayed in this lesion, follow-up of any case of odontogenic keratocyst with roentgenograms and clinical examination of basal cell carcinoma are essential for at least five years after surgery. We report the result of 7-year follow up after cyst enucleation associated with basal cell nevus syndrome with the literature of review.

Surgical Treatment of Type II Talar Neck Fractures (제 2형 거골 경부 골절의 수술적 치료)

  • Jeon, Taek-Soo;Kim, Sang-Bum;Kim, Sung-Hun;Kim, Tae-Kyun;Kim, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.91-96
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    • 2007
  • Purpose: To evaluate the clinical results and determine appropriate methods of surgical treatment about type II talar neck fracture. Materials and Methods: Among nineteen patients who received surgical treatment for type II talar neck fracture from May 2000 to May 2005. Fourteen patients with a follow-up period of more than 1 year were divided into two groups. Six patients reduced by closed reduction (Group A) with screw fixation and eight patients reduced by open reduction with screw fixation. We analyzed preoperative, postoperative and follow-up simple radiographs and reviewed patient hospital records retrospectively. Clinical results were evaluated by Hawkins scoring system. We analyzed pain, limp, range of motion of ankle and subtalar joint. Results: Five patients (83.3%) in group A and seven patients (87.7%) in group B had excellent and good clinical results. There were no complications including avascular necrosis, delayed union, nonunion. Conclusion: Closed reduction with screw fixation of talar neck fracture shows correct reduction and satisfactory results. But because of short term period of follow-up, we need long term results.

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Exposure and Immune Status of Health Care Workers Accidentally Exposed to Hepatitis B Virus in a Healthcare Setting (의료종사자들의 B형간염 노출과 면역상태 조사)

  • Kim, Og-Son;Yoon, Sung-Won
    • Journal of Korean Biological Nursing Science
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    • v.11 no.2
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    • pp.120-127
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    • 2009
  • Purpose: The study aimed at monitoring the immune status of health care workers (HCWs) of a tertiary hospital after accidental exposure to Hepatitis B virus (HBV). Methods: Between January 2004 and December 2006, 353 cases of exposure to Hepatitis B virus were reported. The HBV-exposed HCWs were required to undergo follow-up serum tests to analyze their immune status one year after the exposure. The obtained data were then analyzed to determine the incidence of exposure and of sero-conversion. Results: In this hospital, an average of 9.8 cases of Hepatitis B exposure among HCWs was reported in a month. Follow-up tests conducted after exposure revealed that 90.4% of the HBV-exposed HCWs were positive for Hepatitis B antibody and 66.9% of the HBV-exposed HCWs were reported to have antibody levels exceeding 10 mIU/mL. Results of serum tests for the HBV antigen conducted one year after exposure were negative for all the exposed HCWs. Conclusion: Among the 79.6% of the HCWs who underwent serum tests one year after exposure the HBV sero-conversion rate was 0.0%. However, a further investigation in the form of long-term and multi-center studies is required to confirm this result. Furthermore, an active system should be established to ensure that all exposed HCWs undergo follow-up serum tests.

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Role of the medical claims review (의적클레임검토의 역할 및 기능)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.26
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    • pp.31-39
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    • 2007
  • Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

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Change of Magnetic Motor Evoked Potentials in Hemiparesis due to Cerebral Infarction (뇌경색에 의한 편측부전마비에서 자기운동유발전위의 변동)

  • Lee, Ju Ho;Park, Young Huk;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
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    • v.1 no.2
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    • pp.99-105
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    • 1999
  • Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

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Minimally Invasive Multi-Level Posterior Lumbar Interbody Fusion Using a Percutaneously Inserted Spinal Fixation System : Technical Tips, Surgical Outcomes

  • Kim, Hyeun-Sung;Park, Keun-Ho;Ju, Chag-Il;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.441-445
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    • 2011
  • Objective : There are technical limitations of multi-level posterior pedicle screw fixation performed by the percutaneous technique. The purpose of this study was to describe the surgical technique and outcome of minimally invasive multi-level posterior lumbar interbody fusion (PLIF) and to determine its efficacy. Methods : Forty-two patients who underwent mini-open PLIF using the percutaneous screw fixation system were studied. The mean age of the patients was 59.1 (range, 23 to 78 years). Two levels were involved in 32 cases and three levels in 10 cases. The clinical outcome was assessed using the visual analog scale (VAS) and Low Back Outcome Score (LBOS). Achievement of radiological fusion, intra-operative blood loss, the midline surgical scar and procedure related complications were also analyzed. Results : The mean follow-up period was 25.3 months. The mean LBOS prior to surgery was 34.5, which was improved to 49.1 at the final follow up. The mean pain score (VAS) prior to surgery was 7.5 and it was decreased to 2.9 at the last follow up. The mean estimated blood loss was 238 mL (140-350) for the two level procedures and 387 mL (278-458) for three levels. The midline surgical scar was 6.27 cm for two levels and 8.25 cm for three level procedures. Complications included two cases of asymptomatic medial penetration of the pedicle border. However, there were no signs of neurological deterioration or fusion failure. Conclusion : Multi-level, minimally invasive PLIF can be performed effectively using the percutaneous transpedicular screw fixation system. It can be an alternative to the traditional open procedures.

Correction of Sesamoid after Proximal Metatarsal Osteotomy and Distal Soft Tissue Procedure in Hallux Valgus (무지외반증 치료에서 근위 중족골 절골술과 원위 연부조직 교정술 후 종자골의 교정정도)

  • Jung, Hwa-Jae;Shin, Hun-Kyu;Chang, Il-Sung;Lee, Jong-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.74-80
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    • 2005
  • Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.

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A Development of a Tailored Follow up Management Model Using the Data Mining Technique on Hypertension (데이터마이닝 기법을 활용한 맞춤형 고혈압 사후관리 모형 개발)

  • Park, Il-Su;Yong, Wang-Sik;Kim, Yu-Mi;Kang, Sung-Hong;Han, Jun-Tae
    • The Korean Journal of Applied Statistics
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    • v.21 no.4
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    • pp.639-647
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    • 2008
  • This study used the characteristics of the knowledge discovery and data mining algorithms to develop tailored hypertension follow up management model - hypertension care predictive model and hypertension care compliance segmentation model - for hypertension management using the Korea National Health Insurance Corporation database(the insureds’ screening and health care benefit data). This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques on hypertension care predictive model and hypertension care compliance segmentation model was developed by Decision tree analysis. This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation’s building of a Hypertension follow up Management System in the near future by bringing forth representative results on the rise and care of hypertension.