• Journal of the Korea Society of Computer and Information
• /
• v.12 no.2 s.46
• /
• pp.291-297
• /
• 2007

Linking patient's medical records throughout country is required to get patient's accurate information which is helpful for doctor to diagnosis patient's symptoms more exactly. With shortening of time and preventing of retest, patient can be survived or alleviate suffering. Purpose of this paper is to design combined identification system linking patient's RFID card with medical digitalized Chart to share patient's information between the hospitals. With research and review of pre-studied related identification system, standardization, and UCI-RFID linkage study, SPMR(sharing patient's medical record) has been designed for doctors to make a medical treatment properly at the right time and alleviate patient's pain. SPMR(sharing patient's medical record) which will take information needed and pay for information usage to related hospitals has been designed for doctors to make a medical treatment properly at the right time and alleviate patient's pain.

• Journal of Korean Neurosurgical Society
• /
• v.61 no.5
• /
• pp.568-573
• /
• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• Journal of Acupuncture Research
• /
• v.38 no.4
• /
• pp.325-330
• /
• 2021

In this Case Report, a patient with Buerger's disease who had a leg amputation below his lower right knee and a vascular bypass of right leg, developed a wound caused by his prosthetic leg and subjective discomfort. The patient received skin flap surgery but the wound did not heal properly. He was admitted to the Korean Medicine Hospital where his wound, right leg coldness, and phantom pain were treated with combined Korean medicine. The patient was hospitalized again where he underwent micro-drilling surgery. The patient was re-admitted to the Korean Medicine Hospital where he received combined Korean medicine treatment (CKMT) and carbon arc light treatment (CALT) for his wound, leg coldness, stiffness, and hypoplasia. The temperature of his right leg increased, the numeric rating scale score for assessing pain fell from 5 to 1.5, and subjective discomfort was reduced (< 20%) suggesting this may be an effective treatment.

• The Korean Journal of Pain
• /
• v.9 no.2
• /
• pp.426-429
• /
• 1996

Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.3-46
• /
• 2017

Physician's Duty of Information is classified into three categories by legal function: 'Duty of Information to Report' to fulfill the patient's right to know; 'Duty of Information to Guide' patient's convalescing and staying healthy; 'Duty of Information to Contribute' to patient's self-determination. We classify the physician's duty of information because the legal effect from the breach of duty varies accordingly. The legal effect is focused on damage compensation responsibility for breach of duty. When a physician violates 'Duty of Information to Report', he subjects himself to liability of compensation for infringing on the patient's 'Right to Know'. When a physician violates 'Duty of Information to Guide', she subjects herself to liability for general medical malpractice. Finally, when a physician violates 'Duty of Information to Contribute', the physician is basically liable for violation of the patient's 'Right to Self- Determination' which refers to infringement on freedom of choice. However, in the case of situation that patient's refusal to the medical treatment would be presumed, the physician bears all liability for the patient's damage which includes both of property and mental damage.

• Journal of Trauma and Injury
• /
• v.20 no.1
• /
• pp.47-51
• /
• 2007

Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

• Journal of Trauma and Injury
• /
• v.34 no.3
• /
• pp.212-217
• /
• 2021

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

• Korea Journal of Hospital Management
• /
• v.27 no.3
• /
• pp.39-49
• /
• 2022

Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

• Journal of Korean Academy of Nursing
• /
• v.24 no.2
• /
• pp.190-205
• /
• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• The Korean Society of Law and Medicine
• /
• v.9 no.1
• /
• pp.461-503
• /
• 2008

The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. (1) Active euthanasia is prohibited and a doctor who conduct it is punished. (2) Indirect euthanasia can be permitted unless it is against a patient's intention. (3) Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.