• 제목/요약/키워드: Medical control

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Factors for Postoperative Gallstone Occurrence in Patients with Gastric Cancer: a Meta-analysis

  • Chen, Xiang-Jun;Li, Nian;Huang, Ying-De;Ren, Shuang;Liu, Fang;Chen, Lian;Wang, Yong;Chen, Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.877-881
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    • 2014
  • Objective: To evaluate risk factors for gallstones after gastrectomy. Methods: To identify documents published from 1990 to 2011 the Pubmed, Cochrane Library, Springer Link, CBM and WanFang databases were searched and a meta-analysis was performed with RevMan 5.2 software for odds ratios and 95%CIs. Results: Fifteen studies were selected for the meta-analysis. The pooled ORs [95%CIs] were 0.56 [0.43, 0.73], (P<0.0001) for digestive tract reconstruction, 0.80 [0.54, 1.17], (P=0.25) for pylorus preservation, 0.33[0.15, 0.75], (P=0.008) for resection scope of stomach, 0.33 [0.15, 0.75], (P=0.008) for lymphadenectomy, and 0.13 [0.05, 0.33], (P<0.0001) for vagotomy. Conclusions: Digestive tract physical reconstruction and vagus nerve preservation can reduce the morbidity of gallstones after gastrectomy. Total gastrectomy can add to the morbidity of galltones as does increasing the degree of lymph node dissection. There was no significant difference in gallstones with or without pylorus preservation.

A Study on the Applicability of the Population-Based Health Care Model: Focusing on Social Cooperative-type Medical Clinics in a Local Area (인구집단 기반 건강관리모형의 적용가능성 검토: 한 지역의 의료복지사회적협동조합형 의료기관을 중심으로)

  • Lee, Keun-Jung;Oh, Ju-Yeon;Lee, Da-Hee;Hahm, Myung-Il;Lee, Jin-Yong
    • Quality Improvement in Health Care
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    • v.26 no.2
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    • pp.95-103
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    • 2020
  • Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.

Proposal for Comprehensive Quality Control of Heavy-Ion Medical Accelerator

  • Kim, Dong-wook;Shin, Dong-oh;Shin, Young-hoon;Heo, Hyun-do
    • Progress in Medical Physics
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    • v.28 no.2
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    • pp.67-75
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    • 2017
  • Prior to the introduction of a medical apparatus based on heavy-ion medical accelerator in Korea, a study is needed on quality control in clinical operation for the safe and appropriate usage of the instrument. Data relevant for the study were obtained via information sharing sessions and visits by the Particle Therapy Co-Operative Group (PTCOG) and other related academic associations. Furthermore, investigative analysis of the European and Japanese performance evaluation guidelines for heavy ion, as well as research on relevant literature, were conducted. In addition, instrumental standards were analyzed through an investigation of the current usage status of the heavy-ion medical accelerator, and further analysis was conducted on the evaluation methods for the performance, safety, and significance of the instrument. Based on these analyses, regular quality control procedures for heavy-ion medical accelerators in hospitals and other institutes were extrapolated. It is hoped that the results of this study will facilitate hospitals that have introduced heavy-ion medical accelerators, or are considering the implementation of the instrument, in their understanding of the fundamental standards and capabilities of the treatment system, as well as in establishing and carrying out quality control procedures for clinical operations such that it will contribute to the safety of patients and the efficiency of medical practitioners.

A phenomenological study on the emotional changes of medical students according to the phase of medical education (의학교육 시기에 따른 의과대학생들의 정서 변화에 대한 현상학적 연구)

  • Lee, Won Kyoung;Park, Kyung Hye
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.86-93
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    • 2020
  • The study aimed to understand medical students' experiences of emotional changes, including their method of adapting to experiences, and the effect of the experiences in shaping their identities. We interviewed 12 medical students who were finishing their 1-year clinical internship in 2016. Data on their opinions and reasons for emotional changes during their school life were obtained. The descriptive phenomenological approach was applied to analyze the interviews. Their stress came from disappointment in themselves, competitive environment, observing a change in their personalities, meeting their parents' expectations, and interpersonal relations. The interviewees adjusted to the medical study by exercising self-control in their studies and daily lives, by practicing self-acceptance and observing their state of mind, and by breaking free from the competition-driven environment and obsession with grades. In addition, they cultivated endurance and found external support. Finally, they achieved self-efficacy and were comfortable in their identity as medical students. They still had to address the stress from working relationships and the difficulty in balancing studies and life. The medical students' self-evaluation and compulsive tendencies increased during the medical course due to the burden of studies. They evolved by learning self-control and introspection and seeking ways to adapt. Understanding this growth process of medical students will improve student support in medical schools.

Breathing control with a visual signal for aperture maneuver with controlled breath (AMC)

  • Suh, Ye-lin;Yi, Byong-Yong;Ahn, Seung-Do;Klm, Jong-Hoon;Lee, Sang-Wook;Shin, Seong-Soo;Choi, Eun-Kyung
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.140-143
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    • 2004
  • To appropriately control or compensate breathing motion of targets in thorax or abdomen during radiotherapy is still demanding. Our idea is that a visual signal may help regulate patient's breathing pattern, by controlling its amplitude and cycle. The system involving breathing control with a visual signal for aperture maneuver with controlled breath (AMC) has been developed. A thermocouple is used to detect the temperature change due to patient's breathing. The system also consists of a mask, in which the thermocouple is installed, an operational amplifier, a converter, etc. Patients were instructed to control their respiration by breathing following the visuals signal, as watching a display that shows both patients' current breathing pattern and the signal. The patterns of patients' controlled breathing and the signals coincided well. Therefore, when AMC technique is applied, a target moves in the range that is 60 % less than the range of free breathing motion with the help of the system and so target margins can be reduced significantly. This study reveals that a visual signal is not only useful to control patient's breathing but also clinically effective.

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Paramedic students' awareness and performance of infection control on ambulance attendant training (응급구조학과 학생들의 구급차 동승실습 중 감염관리에 대한 인지도 및 수행도)

  • Lee, Hyun-Ju;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.21-35
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    • 2016
  • Purpose: This study aims to investigate awareness and performance of infection control during ambulance attendant training, and to provide basic data for infection control. Methods: The subjects were 235 paramedic students who completed ambulance attendant training. There were 51 questions. The infection control dimension was divided into hand washing, personal protective equipment use, and environmental management, for each sub-dimension, awareness and performance were measured by a 4-point scale. The collected data were analyzed using SPSS statistics ver. 22.0. Results: A total of 95.3%, of the subjects completed an orientation for ambulance attendant training and 71.7% received education on infection. In all three sub-dimensions, hand- washing (p<.001), personal protective equipment use (p<.001), and environmental management (p<.001), awareness scored higher than performance. The awareness of infection control showed a significantly positive correlation (r=.394) with performance. Conclusion: In order to improve performance of infection control, education to improve awareness should be provided, and paramedics with higher performance levels in hand washing, and use of gloves and masks wearing should be assigned as training advisors.

Associations Between XRCC1 Arg399Gln, Arg194Trp, and Arg280His Polymorphisms and Risk of Differentiated Thyroid Carcinoma: A Meta-analysis

  • Du, Yang;Han, Li-Yuan;Li, Dan-Dan;Liu, Hui;Gao, Yan-Hui;Sun, Dian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5483-5487
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    • 2013
  • Background: Associations between Arg399Gln, Arg194Trp and Arg280His polymorphisms of the XRCC1 gene and risk of differentiated thyroid carcinoma (DTC) have been widely studied but the findings are contradictory. Methods: We performed a meta-analysis in the present study using STATA 11.0 software to clarify any associations. Electronic literature databases and reference lists of relevant articles revealed a total of 10, 6 and 6 published studies for the Arg399Gln, Arg194Trp and Arg280His polymorphisms, respectively. Results: No significant associations were observed between Arg399Gln and DTC risk in all genetic models within the overall and subgroup meta-analyses, while the Trp/Trp vs Arg/Arg and recessive model of the Arg194Trp polymorphism was associated with DTC susceptibility, and the dominant model of Arg280His polymorphism contributed to DTC susceptibility in Caucasians. Conclusions: Our meta-analysis suggests that XRCC1 Arg194Trp may be a risk factor for DTC development.

Development of a Medical Information on Processing, Analysis and Management System (의료정보의 처리, 분석, 관리 시스템 개발)

  • Kim, Hie-Sik;Kim, Gyu-Sik;Choi, Gi-Sang
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.195-198
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    • 1997
  • A medical information management system for small to medium sized clinics and hospitals is developed. The system is designed to process, analyze and manage each patient's clinical record using database technique. The structure of the database was determined and implemented through careful and rigorous study of medical practices in Korea and, therefore, reflects the needs of information management in Korean medical community. Furthermore, a sophisticated inference engine that can deduce possible diseases from the result of medical examination is added to the system to provide doctors with a guideline in medical diagnoses.

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Nurse Attitude-Related Barriers to Effective Control of Cancer Pain among Iranian Nurses

  • Sadeghy, Adel;Mohamadian, Robab;Rahmani, Azad;Fizollah-zadeh, Hussein;Jabarzadeh, Franak;Azadi, Arman;Rostami, Hussein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2141-2144
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    • 2016
  • Background: Many cancer patients still experience pain worldwide. There are many barriers for effective control of cancer pain and many of these are related to health care providers. There is a need for further investigation of these barriers. The aim of this study was to investigate nurse-related barriers to control of cancer pain among Iranian nurses. Materials and Methods: In this descriptive study 49 nurses from two hospitals affiliated to Tabriz and Ardebil Universities of Medical Sciences participated using a census sampling method. A demographic and profession related checklist and Barriers Questionnaire II (BQ-II) were used for data collection. Results: The results showed negative attitudes of participants regarding control of cancer pain. Participants believed that cancer pain medications do not manage cancer pain at acceptable levels; patients may become addicted by using these drugs; cancer pain medications have many uncontrollable effects; and controlling cancer pain may distract the physicians from treating disease. Conclusions: Iranian nurses have negative attitudes toward pain control in cancer patients especially about effectiveness of pain medication and their side effects. Educational intervention to reduce these misconceptions is needed.