• Journal of Oral Medicine and Pain
• /
• 제30권4호
• /
• pp.391-400
• /
• 2005

전문의는 일반의(General Practitioner)와는 차별된 전문성을 가지고 증상의 난이도가 높은 환자를 처리하는 능력이 요구되는 진료과목의 필요성을 기반으로 하고 있다. 또한 전문의제도는 국민의료적인 측면에서 임상 각 분야에 있어 단일과목을 전공하는 의사를 양성하여 그들로 하여금 의료 전 과목에 관한 기본적 이론과 실기를 교육받은 일반의사의 능력에서 벗어나는 진료기능을 의료전달체계에서 담당하도록 하여 국민의료의 향상을 기하는 데 있다. 한편, 구강내과는 악안면 통증, 연조직 질환, 법의치과분야, 구강진단분야를 다루는 전문과목으로서 그 전문성이 매우 중요한데, 구강내과학적 측면에서 비추어 볼 때, 현대화 사회로 갈수록 현대인들은 대도시 중심의 생활환경의 변화와 함께 일상적 스트레스가 증가함에 따라 측두하악장애, 구강내 연조직 질환, 삼차신경통과 같은 신경병변 등의 유병율이 증가하고 있으며, 이에 대한 환자들의 의존도가 높아지고 있는 추세이다. 이에 본 연구는 2004년 8월부터 2005년 4월까지 연세대학교 치과대학병원 구강내과 외래에 내원한 초진환자 3,707명을 대상으로 하여, 의뢰율 및 내원경로를 중심으로 분석한 결과 다음과 같은 결론을 얻었다. 1. 구강내과에 의뢰된 전문 진료분야로는 구강안면통증, 구강 연조직 질환, 법의치과분야, 구강진단분야로 나타났다. 2. 구강내과에 의뢰된 환자의 비율은 58.51%로 과반수를 넘는 환자들이 의뢰되었다. 3. 의뢰환자 중 의뢰기관의 영역분석을 시행한 결과, 치과에서 의뢰된 경우가 83.23%로 가장 많았고 의과 및 한의과 영역에서 의뢰된 경우는 16.78%를 보였다. 4. 자의내원한 환자 중 인터넷 및 매스미디어에서 구강내과 전문분야에 대한 사전 검색 및 주변의 권유에 의해 내원한 환자들이 응답자의 30.52%를 차지하였다. 이상의 결과를 종합해 볼 때, 구강내과는 대부분 의뢰된 환자를 진료하고 있으며, 치과영역 뿐 아니라 의과영역에서의 의뢰율이 높은 것으로 보아 치과영역에서는 일반의들이 치료할 수 없는 수준의 진료영역을 담당하고 있는 것으로 볼 수 있으며 의과학 분야에서는 구강내과학적 전문성을 요하는 질환을 구강내과와 협진하에 해결하려는 것으로 사료되어 전문과목으로서 구강내과학의 역할과 비중이 매우 높음을 확인할 수 있었고, 이는 향후 전문치의제도 인력수급 및 이의 기반이 되는 전공의의 정원책정에서 시장적 접근 및 규범적 접근의 기초자료로 활용되어야 할 것이다.

• Journal of Preventive Medicine and Public Health
• /
• 제57권3호
• /
• pp.252-259
• /
• 2024

Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제30권4호
• /
• pp.339-344
• /
• 2004

The purpose of this study was to evaluate neurosensory disturbance associated with implant surgery performed by implant practitioner (n=47) composed of trained oral surgeon, periodontist, prosthodontist. The incidence, type and duration of sensory disorder were investigated. Anatomical factor of the patient and experience of operator were also evaluated. The result revealed high incidence of inferior alveolar nerve damage (45%) regardless of experience of implant practitioner. The sensory disturbance sustained within 6 months for 61% of cases, which revealed almost normal recovery of nerve function. Initial neurologic sign after nerve damage was not coincide with their consequence of recovery. Half of the practitioners tried surgical intervention to the implants such as removing the fixture, partial unscrewing or re-implant shorter fixture, of which trial regarded as effective measure for 53% of cases. The result indicates that the objective method of sensory nerve evaluation should be introduced to the implant practitioners and the importance of informed consent for possibility of nerve damage in mandibular implant fixation.

• 한국수정란이식학회지
• /
• 제20권1호
• /
• pp.9-15
• /
• 2005

본 연구는 임상 조건하에서 수정란이식의 효율성 증대를 위하여 이식 시술자 측면의 숙련도, 난이도, 소요시간, 주입 위치, 자궁의 출혈 및 위치 조절이 체외수정란이 이식된 수란우의 임신과 유산에 미치는 효과를 검토하였다. 임신율은 숙련된 시술자$(54.2\%)$, 자궁각 2/3 지점에 이식$(46.9\%)$ 및 위치 조절군$(52.9\%)$이 유의하게 높은 경향이었으나, 이식 난이도, 소요시간 및 출혈에 따른 차이는 인정되지 않았다. 한편 시술자 측의 요인에 따른 유산율은 유사한 경향이었다.

• 대한수의사회지
• /
• 제27권11호
• /
• pp.641-660
• /
• 1991

Preventive ear management, early detection and treatment of ear diseases, and effective follow-up evaluations are the best approach to eradicating ear diseases. Up to 50$\%$ of dogs with chronic otitis externa may have concurrent otitis media d

• Journal of Acupuncture Research
• /
• 제24권5호
• /
• pp.151-170
• /
• 2007

Backgraounds : Recent studies provide the evidences that the efficacy of acupuncture may be no better than placebo or inconclusive. These results are very different from those of the actual clinical situations in many acupuncture medical institutions. Objectives : The present study was designed to evaluate the influencing factors which affect the efficacy of acupuncture scale(FEAS) as the methodological assessment tool of acupuncture for examining acupuncture interventions and to demonstrate the importance of it in randomized controlled trials of acupuncture. Data sources : Electronic data were retrieved from NDSL, Pubmed, sciencedirect, LWW, OVID, Black-Well Synergy, Wiley Interscience, EBSCO HOST, springer, PML, and Kluwer. No electronic data were collected from MEDLIS and MEDLAS. Study selection : The inclusion criteria were five systematic reviews included in Alberta study and all randomized controlled trials obtained from their references. Study analysis : The acupuncture rationale, methods of stimulation, treatment regimen, and the practitioner's background were rated by FEAS, and the scores were compared with those by other methodological assessment tools. Results : The number of positive conclusions of high-rank RCTs by FEAS was the same as or higher than that of high-rank RCTs by other methodological assessment tools. Conclusions : We have analysed 5 systematic reviews and their objectives 58 RCTs using FEAS. Practitioner's background has been described slightly in some reviews and studies. It may directly influence the effectiveness of acupuncture negatively in the systematic reviews.

• Tuberculosis and Respiratory Diseases
• /
• 제77권2호
• /
• pp.90-93
• /
• 2014

Hyaluronic acid is widely used in medical procedures, particularly in cosmetic procedures administered by physicians or nonmedical personnel. The materials used for cosmetic procedures by physicians as well as illegally by non-medical personnel can cause nonthrombotic pulmonary embolism (NTPE). We report the case of a woman with acute respiratory failure, neurologic symptoms and petechiae after an illegal procedure of hyaluronic acid dermal filler performed by an unlicensed medical practitioner 3 days before symptom onset. Although a few cases of NTPE after injection of hyaluronic acid have been reported yet, this is the first typical case showing a NTPE manifestation after the facial injection of hyaluronic acid.

• 한국의사학회지
• /
• 제20권1호
• /
• pp.139-164
• /
• 2007

Xu Ling Tai (徐靈胎) was an outstanding medical practitioner in the early and middle part of the Cheong Dynasty of China (淸代). He had learned the study of Confucian classics and natural science from his childhood and read through books covering all sorts of fields, from medical science to hydraulics and literature. He was, in particular, one of leaders who represented the school of classicism that followed scriptures (尊經復古主義學派) in the field of medical science and his solid abstraction has had an affect on posterity's one. One of his masterpieces is Yi Xue Yuan Liu Lun (醫學源流論) among his books in the medical area.

• The Korean Journal of Pain
• /
• 제20권2호
• /
• pp.251-254
• /
• 2007

Perineal pain is a significant diagnostic challenge to the pain practitioner, and accurate diagnosis and treatment is essential. We report a case of 42-years old female patient suffering from excruciating vulvodynia for 5 years. Her pain on the visual analogue scale was 10 out of 10 and her pain was associated with sleep disturbance, dyspareunia, and chronic fatigue. She was diagnosed with a bladder stone by imaging, and The pain was relieved by cystolitholapaxy.

• 대한간호학회지
• /
• 제36권3호
• /
• pp.457-467
• /
• 2006

Purpose: Community health practitioners (CHP) in Korea have a responsibility for delivering primary health care to remote or isolated communities. The aim of this paper is to analyze CHPs' level of depression and impacts of their Ego state and interpersonal attitude in transactional analysis on depression. This paper gives fundamental data for developing a the program for mental health promotion of CHPs. Method: The subjects Of this Study consisted of 459 Korean CHP who were conveniently selected from the target population. The data was collected through interviews using self-administered questionnaires, including the Korean Ego gram and life position inventory and depression scale. Results: The CHP's Ego gram showed the N type with the top point of NP. The type of interpersonal attitude was I'M OK - YOU'RE OK (I+U++). The level of depression was 35.4, normal range. There was a significant difference in depression according to the duration of the career. There was a significant negative correlation among NP, A, FC ego states, interpersonal OK and depression, and a significant positive correlation between interpersonal Not-OK and depression. The NP, A, FC ego states and interpersonal Not-OK were significant predictors (47.1%) of depression. Conclusion: This study showed that a program for CHPs to should include increasing the function of ego states and positive interpersonal attitude.