• 제목/요약/키워드: Medical consultation

검색결과 411건 처리시간 0.024초

전신질환자 구강외과 소수술시의 주의사항 -골다공증약 복용환자 수술 포함- (Guidelines for Dental clinicians in case of medically compromised Patients: Case reports of medically compromised patients taking oral Bisphosphonate)

  • 김선종;김명래
    • 대한치과의사협회지
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    • 제48권7호
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    • pp.538-546
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    • 2010
  • Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.

간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고 (Severe Recurrent Gingival Bleeding and Toothache Control in a Patient with Liver Cirrhosis and Oral Metastatic Hepatoma: Report of a Case)

  • 이천의;모동엽;유재하;최병호;김종배
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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    • pp.592-596
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    • 2010
  • The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

제 5차 WHO 경혈 위치 국제표준화 회의 보고 (Report on the 5th WHO Informal Consultation on Development of International Standard Acupuncture Points Locations)

  • 김용석;강성길;손인철;황혜숙;최선미;구성태
    • Korean Journal of Acupuncture
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    • 제24권2호
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    • pp.113-127
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    • 2007
  • Objectives : To inform the 5th WHO Informal Consultation meeting on Development of International Standard Acupuncture Point Locations, held in Osaka, Japan, on September $27{\sim}29$, 2005. Results and Conclusions : Nine experts from Korea, China and Japan discussed the principles of acupuncture points locations and the point locations of 33 controversial acupoints that were not agreed at the previous meeting, as well as 328 non-controversial points that all 3 nations agreed on the locations to confirm the expression of every single point. Through this meeting, the locations of ST30, SP12, LR7 and expressions of LU6, LI8, LI9, LI10, LI 13, SP13, BL60, KI3, GB38, LR11, LR12 were agreed. Furthermore, locations of BL39, GB27, GB28 were confirmed out of 6 non-discussed points. However, several points were still required to held additional meeting to discuss. That includes LI19, LI20, ST36, ST37, ST38, ST39, SI6, KI9, PC8, PC9, TE9, TE17, TE23, GB7, GB30, GV26. In addition, foundation for the international society for the acupuncture point location was proposed to make a regular revision of standard acupuncture point location.

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서울시 50대 정신건강검진사업에 대한 웹기반 조사 (Web-Based Survey on the Mental Health Screening of the Baby-Boomer Generation)

  • 안승민;이미경;이소희;석정호;이해우;강석훈;백종우
    • 대한불안의학회지
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    • 제13권2호
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    • pp.108-114
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    • 2017
  • Objective : A pilot project entitled '50s mental health screening project' was conducted in Seoul. As a part of this project, we conducted surveys to obtain the opinions of psychiatrists regarding mental health screenings. Methods : A questionnaire was mailed to members registered with the Korean Neuropsychiatric Association, which enquired about the '50s mental health screening project'. Results: A majority (90.9%) of the subjects agreed on the purpose and implementation of the project. However, there were fewer individuals that actually showed the intent to participate (65.8%). The mean age of the group with the intention to participate was higher compared to the group with no intention to participate. The factors that negatively affected the intent to participate included prejudice and discrimination against psychiatry (3.795), low health insurance reimbursement (3.784), and inconvenience of reporting to public health centers (3.664). The most appropriate method that scored the highest for screening mental health was face-to-face consultation with a psychiatrist (3.889). Most of the participants agreed on the method of a self-reported survey along with an interview of psychiatrist (84.9%). Conclusion : Subjects were concerned about prejudice and discrimination against psychiatry, low health insurance reimbursement, and inconvenience of reporting to public health centers. These problems need to be supplemented. Face-to-face consultation with a psychiatrist may be considered an appropriate method for future mental health screening.

우리나라 병원에서의 영양지원팀 운영과 관련된 문제점에 관한 연구: 한 대학병원의 경우 (Problems Associated with the Management of Nutrition Support Team in Hospitals in Korea)

  • 강혜진;스리니바산샨무감;용철순;김정애;이종달;유봉규
    • 한국임상약학회지
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    • 제18권1호
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    • pp.45-49
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    • 2008
  • The goal of this research was to identify problems associated with the management of nutrition support team (NST) in hospitals in Korea. Management status of NST in the hospitals was surveyed over the phone or interviewed by visit during August 2007. NST in foreign countries was collected by reference search and websites in the internet. Survey analysis also was performed during March, 2007 with forty-one medical staff in a university hospital located in Jinju, Kyungsangnamdo. Korean Society for Parenteral and Enteral Nutrition (KSPEN) was organized in 2001 and currently has thirty-three member hospitals with on-site NST as of August, 2007. Most of the member hospitals were big hospitals with more than 500 beds and were organized within five years. The most significant problem identified was the shortage of nutrition specialists exclusively involved in the NST. Survey analysis revealed that more than half of medical staff prescribed parenteral nutrition based on their own nutrition requirement calculation rather than consultation with NST. It appears that status of NST management of hospitals in Korea are considered to be at beginner stage and therefore, needs more aggressive advertising activity to increase consultation usage by medical staff.

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상호참여형 원격진료를 위한 효율적인 객체관리 ((Efficient object control for remote medical examination of mutual participation type))

  • 김석수
    • 한국컴퓨터산업학회논문지
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    • 제3권9호
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    • pp.1245-1250
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    • 2002
  • 본 논문은 누구나 참여할 수 있는 웹상에서의 시공간을 초월한 on-line 및 off-line 겸용모드의 지능형 원격 진료시스템으로서, 데이터베이스는 IIS 4.0 웹서버 상에서 ASP와 SQL을 연동한 구현하여 효율적인 자료처리를 위한 시스템 통합과 환자와 의사 및 한의사간의 on-line 상담, 그리고 off-line상에서의 진료와 환자가 지정한 약사로의 처방전 전송 및 조제, 그리고 진료데이터의 저장 및 검색으로 인한 반영구적인 진료데이터저장이 가능하며, 가족간의 진료데이터 검색 및 공유등 유전에 대한 치료효과 및 개인 병력관리를 통한 과거진료상황에 따른 빠른 치료효과 및 의사간의 협조진료등이 가능한 지능형 객체관리를 이용한 데이터베이스 구성이 되어있다.

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한방병원 입원환자의 진료비 구조 분석 (Medical Expenses Structure on Hospitalized Patients of an Oriental Medical University Hospital)

  • 서미경;이석구
    • 보건행정학회지
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    • 제6권2호
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    • pp.115-130
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    • 1996
  • This study was performed to investigate the practical oriental medical expenses by the use of internal data of an oriental hospital due to the bias of medical insurance program data. The purpose of this study was to describe prevalent diseases of clinical department in the studied hospital, to analyze medical expenses structure and to verify the each cost share ration of expenses on insurer to insuree. Under this purpose, we analyzed actual medical expenses data of 1,611 hospitalized patients of the oriental medical university hospital with 150 beds that can be approached to internal data from Jan. 1, 1994 to Dec. 31, 1994. The major findings are as follows : 1. Upper five of most frequent diseases of admitted patients were Joul-Jung-Pung(55.5%), Yoo-Kak-Tong(7.3%), Yoo-/Tong(7.1%), Gu-An-Wa-Sa(2.7%) and sequale of Joul- Jung-Pung(2.4%) 2. In medical expenses structure, hospital ward fee was 47.1%, medication fee 41.3%, fee for procedure(acupuncture, moxibustion, negative therapy, physical therapy, etc) 11.1% and consultation fee 0.5%. In addition to the cost share ration of insuree & that of insurer was 75:25 respectly.

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제 4차 WHO 경혈 위치 국제표준화 회의 보고 (Report on the 4th WHO Informal Consultation on Development of International Standard Acupuncture Points Locations)

  • 임윤경;김용석;구성태;손인철;박히준;이혜정;이지영;강성길
    • Korean Journal of Acupuncture
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    • 제22권2호
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    • pp.1-8
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    • 2005
  • Objective: To inform of the 4th WHO informal consultation meeting on the development of international standard acupuncture points locations, held in Daejeon, Korea, on April $23{\sim}26$, 2005. Results and Conclusions: 12 experts from Korea, China and Japan discussed the locations of 18 controversial points that were not agreed at the previous meeting, and 16 non-controversial points that all 3 nations agreed on the locations but still needed more discussion for their expressions, as well as other non-controversial points that were agreed on both the locations and the expressions but were suggested by Chinese party to be discussed again. Also, the guidelines for English translation of the standard acupuncture points locations and the development of the standard acupuncture points charts, diagrams, and dolls were discussed in this meeting. Through this meeting the locations of ST30, SP11, SP12, TE18, GB9, GB10, LR4, LR5, LR6, BL6, BL7, BL9, GB19 were agreed, but it was suggested that more research would be needed for the locations of LI20, GV26, PC8, PC9, LR7, GB30, LR12, and the expressions of ST36, ST38, ST39, BL1. Due to the time limitation, 16 acupuncture points out of those Chinese party suggested to have more discussion about were not discussed at this meeting and remained to be discussed at the next meeting.

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119구급차로 이송된 환자의 병원 전 전문응급처치에 관한 조사 (A Analysis of Prehospital care on the patients Transported via 119System)

  • 박진옥;이경희;노상균;최청숙
    • 한국응급구조학회지
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    • 제7권1호
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    • pp.127-134
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    • 2003
  • An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.

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진료과목 관련성을 중심으로 분석한 의학적클레임검토 유형론에 관한 연구 (A study on the typology of the medical claims review in terms of hospital department)

  • 이신형
    • 보험의학회지
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    • 제27권1호
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    • pp.33-36
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    • 2008
  • BACKGROUND : The medical claims review(MCR) is unique methodology of medical consultation in terms of insurance claim administration in Korean insurance market. The most important practical matter in the MCR is formatted question. In Korea, medical specialty is composed of 26 legally defined hospital departments. It is worth of studying to investigate type of MCR by hospital departments. METHODS : Fifty Cases of the MCR were selected randomly by statistical program SPSS among 1,032 cases which were performed between April 1, 2006 and March 31 2007. All of selected cases were evaluated one insurance doctor and made a score points from 0 to 10 in terms of hospital department. RESULTS : Multidimensional scaling was performed. The MCR types - diagnosis, malignancy and cause of death are located in the same 2-dimensional configuration area. It can be called as verification of benefit. Others are advice. - such as causality, interpretation, translation, independent medical examination, and so on. DISCUSSION : We can conclude the classification of MCR typology are two main subjects, verification and advice. Theses results are same as previous article which was based on experience.

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