• 제목/요약/키워드: Medical Records Systems

검색결과 141건 처리시간 0.036초

유방암 환자의 민간요법 (Folk Remedies used by Patients with Breast Cancer)

  • 박진미;정복례
    • 대한간호학회지
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    • 제25권3호
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    • pp.419-430
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    • 1995
  • There is a need to investigate folk remedies used by patients with breast cancer because there is little information about the subject, even though many Korean women with breast cancer have used folk remedies during and after their treatment. The purpose of this study was to investigate and describe the phenomena and the meaning of folk remedies in order to better understand patients with breast cancer and to suggest directions for comprehensive nursing care. The Questions for the study were as follows What kinds of folk remedies do patients with breast cancer use\ulcorner What are the routes of knowing about folk remedies in patients with breast cancer\ulcorner What are the patterns of the usage of the folk remedies\ulcorner Why do patients with breast cancer use folk remedies\ulcorner What are the meanings of folk remedies to patients with breast cancer\ulcorner To answer these questions, a qualitative research method was used. Thirty-nine patients were recruited from university teaching hospitals from March, 1993 to November 1994. Many of them underwent either modified radical mastectomy or received various adjuvant therapy including chemotherapy, radiation therapy, and hormonal therapy. Data were collected by in-depth interviews, observations, medical records, and analyzed step-by-step using qualitative analysis. The results were as follows : 1. Patients with breast cancer have used many different kinds of folk remedies. 2. Patients with breast cancer did not know the exact effects of the folk remedies. Also the effects could not be exactly proven by the patients. 3. Patients with breast cancer received information about many kinds of folk remedies through various communication systems, such as other patients, their families and relatives, friends, and many types of mass media. 4. To use the folk remedies was one kind of illness behavior that was used by these patients. 5. Folk remedies were used to deal with not only anxiety by the patients themselves but also as the expression of affection and concern by families and relatives. 6. The use of folk remedies was one of the adaptation behaviors in patients with breast cancer whose disease was in the terminal stage. Based on the above findings, one suggestion was made : To continue further studies on folk remedies used by other patients with cancer in order to further explain health and illness behavior of Korean people.

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두개 악안면 수술 후 플레이트 제거에 관한 후향적 연구 (The Removal of Plates after Craniomaxillofacial Surgery: A Retrospective Study)

  • 박대균;유상철;박승하;구상환
    • Archives of Plastic Surgery
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    • 제34권2호
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    • pp.186-190
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    • 2007
  • Purpose: Plate systems have been used for osteosynthesis of cranial and oromaxillofacial fracture. However, there is no consensus on the need for routine removal of plate and the question about indications of removal. Therefore, we present the retrospective study to clarify the indications and consensus of removal. Methods: The medical records of patients who were treated with rigid internal fixation using plates after craniofacial trauma were reviewed. Study variables included age, gender, type of fracture, type of plate, seniority of the operator, causes of removal, and time between insertion and removal. All results amendable to statistics were analyzed using SPSS 10.0 to determine which set of variables might affect the fate of the plates. Results: For a period of 10 years (March 1, 1994 through July 31, 2004), total of 41 plates(6.7%) were removed among 609 plates inserted into 419 patients; 27 plates were removed from 15 patients for infection, which is the most common cause of removal accounting for 65.8%. Mean time between insertion and removal is 35.2 months and mean age is 41.4 years. Most plates were removed from combined fracture(14.92%) and facial fracture(8.47%) and these were statistically significant. The age, gender, seniority of the operator and other variables were not statistically associated with plate removal. Conclusion: This retrospective study shows that routine removal does not appear to be clinically indicated due to respectively low removal rate and that the commonest indications for removal were infection.

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea

  • Kim, Hyunmee;Kim, Woojin;Choi, Jee Eun;Kim, Changsoo;Sohn, Jungwoo
    • Journal of Preventive Medicine and Public Health
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    • 제51권6호
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    • pp.265-274
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    • 2018
  • Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than $10{\mu}m$ in aerodynamic diameter, nitrogen dioxide [$NO_2$], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Methods: The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants. Results: Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of $NO_2$ was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of $NO_2$ at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291). Conclusions: The results of our study suggest that ambient air pollution, specifically $NO_2$, is associated with ED visits for diabetic coma.

Proposal for a modified classification of isolated zygomatic arch fractures

  • Jung, Seil;Yoon, Sihyun;Nam, Sang Hyun
    • 대한두개안면성형외과학회지
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    • 제23권3호
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    • pp.111-118
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    • 2022
  • Background: Although the zygomatic arch is an important structure determining facial prominence and width, no consensus exists regarding the classification of isolated zygomatic arch fractures, and the literature on this topic is scarce. To date, five papers have subdivided zygomatic arch fractures; however, only one of those proposed classifications includes the injury vector, although the injury vector is one of the most important factors to consider in fracture cases. Furthermore, the only classification that does include the injury vector is too complicated to be suitable for daily practice. In addition, the existing classifications are clinically limited because they do not consider greenstick fractures, nondisplaced fractures, or coronoid impingement. In the present study, we present a rearrangement of the previously published classifications and propose a modified classification of isolated zygomatic arch fractures that maximizes the advantages and overcomes the disadvantages of previous classification systems. Methods: The classification criteria for isolated zygomatic arch fractures described in five previous studies were analyzed, rearranged, and supplemented to generate a modified classification. The medical records, radiographs, and facial bone computed tomography findings of 134 patients with isolated zygomatic arch fractures who visited our hospital between January 2010 and December 2019 were also retrospectively analyzed. Results: We analyzed major classification criteria (displacement, the force vector of the injury, V-shaped fracture, and coronoid impingement) for isolated zygomatic arch fracture from the five previous studies and developed a modified classification by subdividing zygomatic arch fractures. We applied the modified classification to cases of isolated zygomatic arch fracture at our hospital. The surgery rate and injury severity differed significantly from fracture types I to VI. Conclusion: Using our modified classification, we could determine that both the injury force and the injury vector meaningfully influenced the surgery rate and the severity of the injuries.

개인정보 비식별화를 위한 개체명 유형 재정의와 학습데이터 생성 방법 (Re-defining Named Entity Type for Personal Information De-identification and A Generation method of Training Data)

  • 최재훈;조상현;김민호;권혁철
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2022년도 춘계학술대회
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    • pp.206-208
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    • 2022
  • 최근 빅데이터 산업이 큰 폭으로 발전하는 만큼 개인정보 유출로 인한 사생활 침해 문제의 관심도 높아졌다. 자연어 처리 분야에서는 이를 개체명 인식을 통해 자동화하려는 시도들이 있었다. 본 논문에서는 한국어 위키피디아 문서의 본문에서 비식별화 정보를 지닌 문장을 식별해 반자동으로 개체명 인식 데이터를 구축한다. 이는 범용적인 개체명 인식 데이터에 반해 비식별화 대상이 아닌 정보에 대해 학습되는 비용을 줄일 수 있다. 또한, 비식별화 정보를 분류하기 위해 규칙 및 통계 기반의 추가적인 시스템을 최소화할 수 있는 장점을 가진다. 본 논문에서 제안하는 개체명 인식 데이터는 총 12개의 범주로 분류하며 의료 기록, 가족 관계와 같은 비식별화 대상이 되는 정보를 포함한다. 생성된 데이터셋을 이용한 실험에서 KoELECTRA는 0.87796, RoBERTa는 0.88575의 성능을 보였다.

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발과 발목에서 발생한 종양의 치료 및 예후 (Treatment and Prognosis for Tumors of the Foot and Ankle)

  • 한승수;김정일;고태식;우승훈;김지연
    • 대한족부족관절학회지
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    • 제28권2호
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    • pp.55-59
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    • 2024
  • Purpose: Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors' hospital. Materials and Methods: A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors' hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes. Results: Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery. Conclusion: Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.

Associated Factors and Prevention of Upper Pole Rippling in Prepectoral Direct-to-Implant Breast Reconstruction

  • Da Hye Ryu;Oh Young Joo;Yun Ho Roh;Eun Jung Yang;Seung Yong Song;Dong Won Lee
    • Archives of Plastic Surgery
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    • 제50권6호
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    • pp.541-549
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    • 2023
  • Background Despite its many advantages, prepectoral breast reconstruction also carries the risk of implant rippling. The recent introduction of partial superior implant coverage using a pectoralis muscle slip in prepectoral direct-to-implant (DTI) breast reconstruction has shown the potential to minimize upper pole rippling. The purpose of this study was to identify factors associated with rippling and the effectiveness of our surgical technique. Methods In total, 156 patients (186 breasts) who underwent prepectoral DTI breast reconstruction between August 2019 and March 2021 were identified retrospectively. Patient data were analyzed from medical records. Univariable and multivariable logistic analyses were performed to contextualize the risks associated with rippling deformity relative to demographic characteristics and other clinical factors. Retrospective propensity-matched analysis was performed to identify the relationship between rippling deformity and the reconstruction method. Results Patients with body mass index (BMI; odds ratio [OR], 0.736; p < 0.001), those with a postoperative chemotherapy history (OR, 0.324; p = 0.027) and those who received breast reconstruction via the superior coverage technique (OR, 0.2; p = 0.004), were less likely to develop rippling deformity. The median follow-up period was 64.9 weeks, and there were no significant differences between patients in types of mastectomy, implant, or acellular dermal matrix. Patients who underwent superior coverage technique-based reconstruction showed significantly reduced rippling (OR, 0.083; p = 0.017) Conclusion Patients with higher BMI and prior postoperative chemotherapy were less likely to develop rippling deformity. The superior coverage technique can be effective in minimizing upper pole rippling.

단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 - (Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study)

  • 황희승;이나영;한승범;곽가영;이수영;정승연;강진한;정대철
    • Clinical and Experimental Pediatrics
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    • 제51권11호
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    • pp.1158-1164
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    • 2008
  • 목 적: 저자들은 중환자실에 입원하는 환아들에 대한 소아사망률지표 2 (pediatric index of mortality 2, PIM2)와 소아사망위험도 III (pediatric risk of mortality III, PRISM III)의 유효성을 평가하고자 하였다. 방 법: 2003년 1월부터 2007년 12월까지 단일 기관 중환자실에 입실하여 치료받았던 환아의 의무기록을 후향적으로 조사하였다. 중환자실에 입실하여 2시간 이내에 사망하거나 절망적인 상태의 퇴원인 경우는 제외하였다. 환아들의 일반적인 특성에 대해서 Student's t-test와 ANOVA를, PIM2와 PRISM III 항목에 대해서 생존한 환아와 사망한 환아 사이에 상관분석을 시행하였다. 또한, 사망률 예측의 정도에 대한 정확성을 위해서 Hosmer-Lemeshow 적합도에 대한 다중회귀분석과 수용자 작업특성곡선을 사용하였으며 예측사망율의 과대 또는 과소 평가는 표준화된 사망비를 이용하여 검증하였다. 결 과: 193 증례의 의무기록을 검토하였으나 3예가 중환자실에 입실한 2시간이내에 사망하여 190예에 대하여 분석을 시행하였다. PIM2의 항목들은 수술이나 술기 후에 입원한 경우와 저위험군의 항목을 제외하고 생존과 연관성이 있었다. PRISM III에서는 심혈관/신경계 징후, 동맥혈가스분석의 항목이 관련성이 있었으나 생화학과 혈액학적 검사소견은 연관성이 유의하지 않았다. 수용자 작업특성곡선으로 확인한 예측도는 모두 의의가 있었으며 PIM2의 곡선하면적이 0.858 (95% 신뢰도: 0.779-0.938), PRISM III가 0.798 (95%신뢰도: 0.686-0.891)이었다. 또한, 표준화된 사망비는 두 가지 지표 모두 1에 가까웠으며 다중회귀분석을 이용한 Hosmer-Lemeshow 적합도에서 PRISM III가 ${\chi}^2(13)=12.899$, P=0.456이었으며, PIM2는 ${\chi}^2(13)=14.986$, P=0.308이었다. 그러나 PIM2가 가능도비검정에서 PRISM III보다 유의한 특성을 가지고 있었다(${\chi}^2(4)=55.3$, P<0.01). 결 론: 저자들은 중환자실에 입실하는 소아 환자에서 사망률을 예측하는 두 가지 지표(PIM2, PRISM III)가 의미가 있다는 사실을 확인하였다. 저자들은 PIM2가 PRISM III보다 보다 정확하고 적절하다고 생각된다.

가정용 인공 호흡기를 사용하는 소아의 임상적 고찰 (Clinical Study of Children Using Home Mechanical Ventilation)

  • 안영준;이승현;김효빈;박성종;고태성;홍수종
    • Clinical and Experimental Pediatrics
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    • 제48권4호
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    • pp.401-405
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    • 2005
  • 목 적 : 급성 호흡부전증, 호흡중추장애, 신경근 질환 등으로 인한 만성 호흡부전 환자들이 가정용 인공 호흡기의 도입으로 가정에서 기계 환기를 받을 수 있게 되어 생명을 연장시키고, 삶의 질을 향상시킬 수 있어 그 사용하는 예가 증가하고 있다. 그러나 이에 대한 임상자료가 거의 없어 저자들은 인공 호흡기를 장착한 환아들을 대상으로 임상실태를 조사하였다. 방 법 : 1997년부터 2003년까지 서울아산병원 소아 중환자실에 입원 후 가정용 인공 호흡기를 장착한 21명의 환아들을 대상으로 하여 후향적으로 의무기록을 분석하고 전화면담을 시행하였다. 결 과 : 대상 환아들은 21명으로 남아 15명, 여아 6명이었다. 인공 호흡기를 장착하였을 때 중간 연령은 31개월(범위 : 2-150개월)이었으며, 호흡기를 장착한 중간 기간은 25개월(범위 : 2-68개월)이었다. 환아들의 원인 질환으로는 호흡중추장애를 포함한 신경근 질환이 16례, 급성 호흡곤란을 포함한 폐질환이 4례, 유전성 대사질환이 1례였다. 인공 호흡기 양식은 압력 조절 양식이 16례(76%), 용적 조절 양식이 5례(24%), 산소가 필요한 경우는 13례(62%)였고, 인공 호흡기를 조금이라도 이탈할 수 있었던 경우는 3례(14%)였다. 기계고장은 19개월마다 1회 발생하였고, 인공 호흡기 장착 후 평균 입원 횟수는 매년 1.7회, 그 원인으로는 폐렴(68%)이 가장 많았다. 추적 관찰한 결과 사망한 환아는 9명(43%)이었고, 사망원인은 기관지 튜브 폐쇄가 4례였다. 인공 호흡기 대여, 산소발생기, 영양식, 진찰 및 치료비용 등을 포함한 모든 의료비용은 월간 평균 111만원이었다. 결 론 : 최근 가정용 인공 호흡기 사용이 증가하고 있으며, 사망원인으로 기관지 튜브 폐쇄가 많아 주의 및 관리를 필요로 하고 인공 호흡기를 장착한 가정에 경제적 어려움이 있어 사회적 관심과 제도적 지원이 필요할 것으로 사료된다.

한의 개인건강기록 플랫폼 구축에 관한 연구 (Study on Korean Medicine Personal Health Record Platform)

  • 서진순;김안나;김상현;이승호;남보령;이명구;장현철
    • 동의생리병리학회지
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    • 제30권6호
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    • pp.458-465
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    • 2016
  • The information relating to the health of person has been increasing. The information is such as medical information and personal health record and the information collected by utilization and dissemination of mobile devices. Therefore, the interest and demand for systems that can integrate and manage the Personal Health Record(PHR) is increasing. Quantity and quality of information that is collected from the patient can have a major impact on the diagnosis and treatment of Korean Medicine(KM) in clinical practice. Because closely observe the usual clinical symptoms of patients to utilize the treatment. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. Therefore, the personal health care services that can record and manage and own is necessary based on KM. In this paper, we propose Korean Medicine Personal Health Record Platform(KM PHR Platform). We have selected the significant symptoms that mean to the personal records from symptom information required for diagnosis in KM. And classifying and scoring as the symptoms were used as personal health care indicators. And significant symptoms were easily configure a screen that can be recorded. simple operation is recorded as a symptom. It was designed to reflect these functions. So KM PHR Platform helps to Personal health care. Doctor may be able to help in the diagnosis and prognosis observation by reference to shared symptom. We look forward to a variety of health services based on KM using a symptom, a medical record, personal health device information.