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Levels of Physicians' Self-assessment of Life Satisfaction and Associated Factors (임상의사의 삶의 만족도 자가평가 수준과 관련 요인)

  • Jong Sun Ok;Hyeongsu Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.1
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    • pp.28-40
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    • 2023
  • Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

The treatment of an edentulous patient with DENTCA$^{TM}$ CAD/CAM Denture (CAD/CAM Denture를 이용한 완전 무치악 환자 수복 증례)

  • Park, Joon-Ho;Cho, In-Ho;Shin, Soo-Yeon;Choi, Yu-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.19-25
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    • 2015
  • Nowadays, CAD/CAM is broadly used in dentistry for inlays, crowns, implant abutments and its spectrum is expanding to complete dentures. Utilizing CAD/CAM to fabricate complete dentures is expected to decrease chair time and the number of visits, thus decreasing total fabrication time, expenses and errors caused during fabrication processes. One of the systems using CAD/CAM, DENTCA$^{TM}$ CAD/CAM denture (DENTCA Inc. Los Angeles, USA) scans edentulous impressions, designs dentures digitally, fabricates try-in dentures by 3D printing and converts them into final dentures. Patients can wear final dentures after only 2 - 3 visits with satisfying adaptation. This case report introduces a 71-year-old male patient who visited to consult remaking of existing old dentures. Residual teeth with bad prognosis and root remnants were extracted and the patient used reformed existing mandibular denture for 2 months. And then DENTCA system started. One-step border molding was done using conventional tray of adequate size provided by DENTCA system and wash impression was taken. Gothic arch tracing was completed based on the vertical dimension of existing dentures. Both maxillary and mandibular trays were placed to the resultant centric relation and bite registration was taken. Then DENTCA scanned the bite registration, arranged the teeth, completed the festooning and fabricated the try-in dentures by 3D printing. The try-in dentures were positioned, occlusal plane and occlusal relations were evaluated. The try-in dentures were converted to final dentures. To create bilateral balanced occlusion, occlusal adjustment was done after clinical remounting using facebow transfer. The result was satisfactory and it was confirmed by patient and operator.

Extracorporeal Shockwave Therapy for Medial or Lateral Epicondylitis of the Elbow (주관절 내, 외상과염에 대한 체외충격파 치료의 임상적 결과)

  • Yum, Jae-Kwang;Bae, Su-Young;Park, Sung-Bum
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.79-84
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    • 2009
  • Purpose: Medial or Lateral epicondylitis is one of the most common causes of elbow pain and recently ESWT (Extracorporeal Shockwave Therapy) is welcomed as a new treatment modality and has been performed in many clinics. The purpose of this study is to report the clinical result after the ESWT treatment for the lateral or medial epicondylitis of the elbow. Materials and Methods: From Nov. 2005 to Jan. 2009, seventy four cases of seventy two (11 male, 61 female) patients diagnosed as medial or lateral epicondylitis of the elbow are included in this study. The average age was 52.4 years old. Authors used visual analogue scale (VAS) to assess the degree of pain at rest and during work, comparing the score before the ESWT treatment with that of $6^{th}$, $12^{th}$ and $24^{th}$ week after the treatment. Authors also checked the number of awakeness during sleep due to pain and compared them before and after the ESWT treatment. Results: Average resting pain score improved from 4.60 before the treatment to 2.01 at $6^{th}$ week, 0.43 at $12^{th}$ week and 0.16 at $24^{th}$ week. Average pain score during working also showed quite an improvement with time from 7.20 before the treatment to 4.05 at $6^{th}$ week, 2.01 at $12^{th}$ week and finally 0.36 at $24^{th}$ week. We checked the frequency of sleep arousal during a week, and also found similar significant treatment efficacy as the average frequency decreased from 9.64 per week before the treatment to 1.21, 0.08 and 0.09 per week at $6^{th}$ week, $12^{th}$ week and $24^{th}$ week, respectively. Conclusion: ESWT for medial or lateral epicondylitis is thought to be one of the effective treatment modalities for those patient group not quite responsive to other conservative treatment.

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지역사회 건강관리담당자의 만성질환 관리실태:전라남도를 중심으로

  • Kim, Hye-Sook;Park, Jong;Jeong, Eun
    • Journal of agricultural medicine and community health
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    • v.34 no.3
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    • pp.334-345
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    • 2009
  • Objectives: This study was performed to investigate the management status of chronic disease at community health centers. Methods: The study subjects were 450 employed persons at community health centers in Jeonlanamdo. General characteristics, status of chronic disease management and health education were collected for statistical analysis. The differences on management status among working areas were assessed with chi-square test and ANOVA. Results: The mean values of work duration were 18.7 years in rural, 14.4 years in fishing village, and 17.4 years in urban-rural, respectively. The number of management registration was highest in hypertension. The ways of disease management were medication check-up, diet stopping smoking. The contents of group health education were exercise, diet and prohibition of smoking. The place of health education was town assembling hall. The fields which officials wanted to be educated were symptom, diagnosis, treatment and complication. The most important field was early detection of chronic disease patients and health education. Finally, the field requiring support was work standardization. Conclusions: Community health workers have worked positively in chronic disease management. The barriers to work were the lack of professional and preliminary data. The support system with other health organ and health education were needed for the improvement of working ability.

The evaluate the usefulness of various CT kernel applications by PET/CT attenuation correction (PET/CT 감쇠보정시 다양한 CT Kernel 적용에 따른 유용성 평가)

  • Lee, Jae-Young;Seong, Yong-Jun;Yoon, Seok-Hwan;Park, Chan-Rok;Lee, Hong-Jae;Noh, Kyung-Wun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.2
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    • pp.37-43
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    • 2017
  • Purpose Recently PET/CT image's attenuation correction is used CTAC(Computed Tomgraphy Attenuation Correction). it can quantitative evaluation by SUV(Standard Uptake Value). This study's purpose is to evaluate SUV and to find proper CT kernel using CTAC with applied various CT kernel to PET/CT construction. Materials and Methods Biograph mCT 64 was used for the equipment. We were performed on 20 patients who had examed at our hospital from february through March 2017. Using NEMA IEC Body Phantom, The data was reconstructed PET/CT images with CTAC appiled various CT kernel. ANOVA was used to evaluated the significant difference in the result. Results The result of measuring the radioactivity concentration of Phantom was B45F 96% and B80F 6.58% against B08F CT kernel, each respectively. the SUVmax increased to B45F 0.86% and B80F 6.54% against B08F CT kernel, In case of patient's parts data, the Lung SUVmax increased to B45F 1.6% and B80F 6.6%, Liver SUVmax increased to B45F 0.7% and B80F 4.7%, and Bone SUVmax increased to B45F 1.3% and B80F 6.2%, respectively. As for parts of patient's about Standard Deviation(SD), the Lung SD increased to B45F 4.2% and B80F 15.4%, Liver SD increased to B45F 2.1% and B80F 11%, and Bone SD increased to B45F 2.3% and B80F 14.7%, respectively. There was no significant difference discovered in three CT kernel (P >.05). Conclusion When using increased noise CT kernel for PET/CT reconstruction, It tends to change both SUVmax and SD in ROI(region of interest), Due to the increase the CT kernel number, Sharp noise increased in ROI. so SUVmax and SD were highly measured, but there was no statistically significant difference. Therefore Using CT kernel of low variation of SD occur less variation of SUV.

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Analysis of $^{99m}Tc-ECD$ Brain SPECT images in Boys and Girls ADHD using Statistical Parametric Mapping(SPM) (통계적 파라미터지도 작성법(SPM)을 이용한 남여별 ADHD환자의 뇌 SPECT 영상비교분석)

  • Park, Soung-Ock;Kwon, Soo-Il
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.31-41
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    • 2004
  • Attention deficit hyperactivity disorder(ADHD)is one of the most common psychiatric disorders in childhood, especially school age children and persisting into adult. ADHD is affected 7.6% in our children, Korea. and persisting into $15{\sim}20%$ in adult. And it is characterized by hyperactivity, inattention and impulsivity. Brain imaging is one of way to diagnosis for ADHD. Brain imaging studies may be provide information two types - structural and functional imaging. Structural and functional images of the brain play an important role in management of neurologic and psyciatric disorders. Brain SPECT, with perfusion imaging radiopharmaceuticals is one of the appropriate test to diagnosis of neurologic and psychiatric diseases. Ther are a few studies about separated analysis between boys and girls ADHD SPECT brain images. Selection of Probability level(P-value) is very important to determind the abnormalities when analysis a data by SPM. SPM is a statistical method used for image analysis and determine statistical different between two groups-normal and ADHD. Commonly used P-value is P<0.05 in statistical analysis. The purpose of this study is to evaluation of blood flow clusters distribution, between boys and girls ADHD. The number of normal boys are 8(6-7y, average : $9.6{\pm}3.9y$) and 51(4-11y, average : $9.0{\pm}2.4$) ADHD patients, and normal girls are 4(6-12y, average : $9{\pm}2.4y$) and 13(2-13y, average $10{\pm}3.5y$) ADHD patiens. Blood flow tracer $^{99m}Tc-ethylcysteinate$ dimer(ECD) injected as rCBF agent and take blood flow images after 30 min. during sleeping by SPECT camera. The anatomical region of hyperperfusion of rCBF in boys ADHD group is posterior cingulate gyrus and hyperperfusion rate is 15.39-15.77% according to p-value. And girls ADHD group appears at posterior cerebellum, Lt. cerbral limbic lobe and Lt. Rt. cerebral temporal lobe. These areas hyperperfusion rate are 24.68-31.25%. Hypoperfusion areas in boys ADHD,s brain are Lt. cerebral insular gyrus, Lt. Rt. frontal lobe and mid-prefrontal lobe, these areas decresed blood flow as 15.21-15.64%. Girls ADHD decreased blood flow regions are Lt. cerebral insular gyrus, Lt. cerebral frontal and temporal lobe, Lt. Rt. lentiform nucleus and Lt. parietal lobe. And hypoperfusion rate is 30.57-30.85% in girls ADHD. The girls ADHD group's perfusion rate is more variable than boys. The studies about rCBF in ADHD, should be separate with boys and girls.

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Sleep Architecture and Physiological Characteristics of Obstructive Sleep Apnea in Split-Night Analysis (수면분할 분석으로 본 수면무호흡증의 수면구조와 생리적 특징)

  • Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.45-51
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    • 2006
  • Obstructive sleep apnea (OSA) syndrome disrupts normal sleep. However, there were few studies to evaluate the asymmetric distribution, the one of the important factors of normal sleep in OSA subjects. We hypothesized that asymmetry would be broken in OSA patients. 49 male subjects with the complaint of heavy snoring were studied with polysomnography. We divided them into two groups based on the apnea-hypopnea index (AHI) fifteen: 13 simple snoring group (SSN, average AHI $5.9{\pm}4.4$) and 32 OSA group (average AHI $47.3{\pm}23.9$). We compared split sleep variables between the first half and the second half of sleep within each group with paired t-test for the evaluation of asymmetry. Changes of sleep architecture of OSA were higher stage 1 sleep% (S1), total arousal index (TAI), AHI, and mean heart rate (HR) and lower stage 2 sleep% (S2), REM sleep%, and mean arterial O2 saturation (SaO2) than SSN subjects. SWS and wake time after sleep onset (WASO) were not different between two groups. In split-night analysis, OSA subjects showed higher S2, slow wave sleep% (SWS), spontaneous arousal index (SAI), and mean HR in the first half, and higher REM sleep% and mean SaO2 in the second half. Those were same pattern as in SSN subjects. Mean apnea duration and longest apnea duration were higher in the second half only in the OSA. No differences of AHI, ODI, WASO, and S1 were found between the first and the second half of sleep in both groups. TAI was higher in the first half only in the SSN. SWS and WASO seemed to be influenced sensitively by simple snoring as well as OSA. Unlike our hypothesis, asymmetric distributions of major sleep architecture variables were preserved in OSA group. Losing asymmetry of TAI might be related to pathophysiology of OSA. We need more studies that include large number of subjects in the future.

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Comparison of Treatment Plans with Multileaf Collimators of different Leaf Width (Leaf width가 다른 다엽 콜리메터에 의한 치료계획 비교)

  • Kim Joo Young;Park Sung Yong;Lee Doo Hyun;Lee Seok Ho;Kim Tae Hyun;Cho Kwan Ho
    • Progress in Medical Physics
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    • v.15 no.4
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    • pp.173-178
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    • 2004
  • Purpose: To compare desimetrically intensity-modulated radiotherapy treatment plans with commercially available multileaf collimators (MLCs) of different leaf width for intracranial lesions. Materials and Methods: Twelve patients with intracranial lesions were treated with BrainLAB's micro-MLCs (mMLCs) and performed with the BrainSCAN ver. 5.2 planning software. They were replanned using the Varian 120 and 80 MLCs. These collimators have minimum leaf width of 3 mm, 5 mm and 10 mm at isocenter, respectively. PTV was $3.3~339.2\textrm{cm}^3$ and the number of beams was 3~7. These three plans were compared with respect to the uniformity and the conformity indices, doses to critical organ and normal tissue. Results: For the uniformity index of the planning target volume (PTV), there were no statistically significant differences between mMLCs and 120 MLCs (p=0.057) and between 120 MLCs and 80 MLCs (p=0.388). However, there was a difference between mMLCs and 80 MLCs (p<0.001). Maximum target dose to the PTV showed no dependency with respect to the leaf width. On the contrary, there were statistically significant differences in the conformity indices between mMLCs and 120 MLCs (p=0.003), between mMLCs and 80 MLCs (p=0.003) and between 120 MLCs and 80 MLCs (p=0.003). The volume of brainstem irradiated to $\geq$70% dose and to $\geq$50% dose was increased as the leaf width of MLCs increased. In particular, the volume of normal tissue irradiated is obviously changed for different leaf width. Volumetric increments for MLCs with leaf widths of 5 mm and 10 mm were 6.3% and 23.2% to the normal tissue irradiated to $\geq$50% dose, and 8.7% and 32.7% to the normal tissue irradiated to $\geq$70% dose, respectively, compared to the volume for MLCs with leaf width of 3 mm. Conclusions: The uniformity index and maximum target dose to the PTV showed no dependency with respect to leaf width of MLCs. However, the conformity index was improved as the leaf width decreased. For the sparing of normal brain tissue, treatment plans with MLCs of 3 mm leaf width is more effective, compared to ones with MLCs of 5 mm and 10 mm leaf widths.

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A Study on the Service Performance and Job Satisfaction of Physical therapists (물리치료사의 근무실태와 직무만족도에 관한 조사연구)

  • Cheon Jae-Kyun
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.9-37
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    • 1991
  • The purpose of this . study is to examine the unsatisfactory factors of the physical therapists and to obtain the materials necessary to comply with these factors by analysing their service performance and job satisfaction, To accomplish these purposes, this study was carried out by using the questionnaires 206 physical therapists registered in the Korean Physical Therapists Association, for 35 days from January 7 to February 10, 1990. The result of this study is summarized as follows. 1. Of total respondents, the male accounted for 54.4 percent, while the female for 45.6 percent. Their age showed that 20s accounted for 65.0 percent, while the service period less than 3 years accounted for 66.5 percent. In addition, 63.6 percent of them served at the general clinics. 2. The general clinics caused the physical therapists to serve for 10 hours or more per day, where their therapy room located in the underground accounted for 41.3 percent. Their health diagnosis status indicated that nondiagnosis accounted for 63.2 percent. The number of the served patients fer a day showed that 20-30 accounted for 37.4 percent, while 30 persons or more for 25.7 percent. 53.4 percent of total subjects was unsatisfied with their duty quantity. And, the monthly salary indicated that 500,000 or less accounted for 72.3 percent. 3. The average marks by their job satisfaction factors indicated 4.42 for duty importance, 4.02 for recognization of specialized job, 3.98 for ability exercise, 1.99 for promotion possibility, 2.28 for reasonable salary, and 2.41 for welfare system, respectively, based on 5 full marks. 4. The summarized job satisfaction by factors indicated that the relation with the doctor accounted for 57.8 percent, the satisfaction status with the existing job for 53.4 percent, the ability development for 41.8 percent, respectively, and the salary for 10.2 percent. Then, the satisfaction by sex showed that the male was generally satisfied with the ability development (p<0.05), the relation with the doctor (p<0.01), and the satisfaction with the existing job, while the female was satisfied with the duty quantity(p<0.05), salary, and the situation guarantee (p<0.05). On the other hand, the satisfaction by age indicated that the subject of the lower age were satisfied with the ability development (p<0.01), the relation with the doctor(p<0.05), the salary, and the situation guarantee. Also, the satisfaction by the service section showed that the physical therapists serving at the general hospital were satisfied with the ability development (p<0.01), the duty quantity (p<0.01), the salary(p<0.01), the situation guarantee(p<0.01), and the satisfaction with the existing duty (p<0.05), while the physical therapists at the hospital and the rehabilitation center were unsatisfied with the salary (p<0.01). In addition, The satisfaction with the service period at the existing section indicated that the physical therapists less than 3 years were highly satisfied with the ability development, the relation with the doctor, the situation guarantee, and the existing duty(p<0.05), while the physical therapists more than 6 years tended to show the lower satisfaction, And the satisfaction with the monthly salary indicated that the higher the monthly salary, the higher the satisfaction with the relation to the doctor(p<0.05), the duty quantity(p<0.01), the salary(p<0.01), and the situation guarantee (p<0.01). 5. The correlation between general characteristics and job satisfaction factors indicated that the sex was directly correlated to the marital status (r=-0.442), while it was reversely correlated to the age (r=-0.564) , total career (r=-0.229), and the relation with the doctor (r=-0.233). Additionally, the age was directly correlated to the total carreer (r=-0.677), and the service period at the existing section (r=0.491), while the age was reversely correlated to the marital status (r=-0.678). Accordingly, the higher job satisfaction of the physical therapists was related to factors such as their duty importance, recognization of specialized occupation, ability exercise, autonomy, relation to colleagues, decision-making's consideration, and relation with the doctor, while the lower job satisfaction includes the opportunity of promotion, salary, welfare system, service time, duty quantity, and situation guarantee. For this reason, if the factors of the lower job satisfaction are solved, then it will be possible to encourage the motive of these physical therapists, and the acyivate their duties. More over, it is also possible to improve the medical service, Additionally, if the general physical therapy room in the hospital and in the public health center are established, more development should be accomplished in the physical therapy.

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Effect of Modified Ultrafiltration on the Postoperative State after Pediatric Open Heart Surgery. (소아 개심술에 있어서 변형 초여과법(Modified Ultrafiltration)이 술후 상태에 미치는 영향)

  • 방종경;천종록;김규태
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.456-465
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    • 1998
  • Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.

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