• Title/Summary/Keyword: Patient Hand-off

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Evaluation of Accessory Navicular Bone Using a Bone Scan and Its Clinical Significance for the Prognosis and Treatment (골 주사 검사를 이용한 부주상골의 평가와 예후 및 치료에 대한 임상적 의의)

  • Park, Sung Hae;Lee, Jun Young;Jang, Hyun Woong
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.62-67
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    • 2018
  • Purpose: To evaluate the clinical significance and usefulness of a bone scan in accessory navicular bone. Materials and Methods: Eighty-five patients with foot pain and accessory navicular bone on radiography, who underwent bone scan from 2012 to 2015, were analyzed retrospectively. The subjects was divided into a symptomatic and asymptomatic group according to the presence of navicular bone tenderness. The grade of bone scan uptake was divided into 3 grades. Age, gender, grade of bone scan and size of the accessory navicular bone were analyzed. The symptomatic group were divided into a low (grade 0, 1) and high uptake (grade 2) group to determine the appropriate treatment. The low uptake group was treated conservatively for 3 months. The high uptake group was initially treated conservatively for 3 months and surgery was performed if pain persisted. For the clinical evaluation, the visual analogue scale, American Orthopaedic Foot and Ankle Society midfoot scale were evaluated in the first examination and last follow-up date. The patient's satisfaction grade was also evaluated at the last follow-up. Results: The asymptomatic group mostly showed no uptake in the bone scan. On the other hand, some patients in the asymptomatic group showed an increase in uptake. In these patients, the size of accessory navicular bone was related to the grade of bone scan uptake, showing that the bone scan uptake grade can be predicted when applying different cut off values for the bone size. The symptomatic group mostly showed uptake in the bone scan and the grade of uptake had a positive correlation with the size of the accessory navicular bone (p<0.05). Age and gender were not related to the bone scan uptake. In the clinical evaluation, conservative and surgical treatment showed a good outcome. Conclusion: The bone scan uptake grade alone cannot be used to completely predict the symptoms. On the other hand, the size of the accessory bone can increase the bone scan uptake. Therefore, the size of the accessory bone, and patient symptoms should be considered in patients with a high uptake when deciding treatment.

Investigation of Standard Evaluation for the Quality Control of General X-ray Systems

  • Kang, Byung-Sam;Son, Jin-Hyun;Kim, Byoung-Jun;Park, Deok-Woo;Jung, Byoung-Hoon;Lee, Hyo-Jin;Hong, Ji-Young;Kim, Seung-Chul
    • Korean Journal of Digital Imaging in Medicine
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    • v.12 no.2
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    • pp.71-79
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    • 2010
  • Thanks to the great development of technology in radiation, we are now able to reduce radiation exposure to the patients, and the radiographer and expenses in medical sector. We are also trying to produce ideal images which maintain useful information. These kinds of effort are increasing over the world. For that reason, we should get images which include necessary data of patients. Then it also can help to reduce radiation exposure to the patients. Therefore, we need to know the problems that cause a falling off in image's quality and check on generator in case of their electronic and mechanical errors. And moreover, we should anticipate the possibility of devices errors and prevent them with regular quality control. This investigation was conducted in medical institutions, institute of educations and hospitals. They are all in Seongnam-City. We used PMX-III, kVp meter to implement kVp test, mR / mAs output test, light fiel / beam alignment test, Reproducibility of exposure dose, half value layer test, reproducibility of exposure time test. in the case of hospitals, they perceive the importance of regular quality control and organize the regular quality control team so they can be satisfied with the error standard in most experiments. On the other hand, when it comes to medical institutions and institute of educations, they perceive the importance of regular quality control less than hospitals do. Radiographer need to understand the importance of regular quality control and practice it so they can get the fine ideal image with the lower dose to the patient.

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SMITH-MAGENS SYNDROME (SMS) : A CASE REPORT (Smith-Magenis Syndrome (SMS) 환아의 증례 보고)

  • Kim, Eun-Young;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.341-347
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    • 2003
  • Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

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Development of 3-D Stereotactic Localization System and Radiation Measurement for Stereotactic Radiosurgery (방사선수술을 위한 3차원 정위 시스템 및 방사선량 측정 시스템 개발)

  • Suh, Tae-Suk;Suh, Doug-Young;Park, Sung-Hun;Jang, Hong-Seok;Choe, Bo-Young;Yoon, Sei-Chul;Shinn, Kyung-Sub;Bahk, Yong-Whee;Kim, Il-Hwan;Kang, Wee-Sang;Ha, Sung-Whan;Park, Charn-Il
    • Journal of Radiation Protection and Research
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    • v.20 no.1
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    • pp.25-36
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    • 1995
  • The purpose of this research is to develop stereotactic localization and radiation measurement system for the efficient and precise radiosurgery. The algorithm to obtain a 3-D stereotactic coordinates of the target has been developed using a Fisher CT or angio localization. The procedure of stereotactic localization was programmed with PC computer, and consists of three steps: (1) transferring patient images into PC; (2) marking the position of target and reference points of the localizer from the patient image; (3) computing the stereotactic 3-D coordinates of target associated with position information of localizer. Coordinate transformation was quickly done on a real time base. The difference of coordinates computed from between Angio and CT localization method was within 2 mm, which could be generally accepted for the reliability of the localization system developed. We measured dose distribution in small fields of NEC 6 MVX linear accelerator using various detector; ion chamber, film, diode. Specific quantities measured include output factor, percent depth dose (PDD), tissue maximum ratio (TMR), off-axis ratio (OAR). There was small variation of measured data according to the different kinds of detectors used. The overall trends of measured beam data were similar enough to rely on our measurement. The measurement was performed with the use of hand-made spherical water phantom and film for standard arc set-up. We obtained the dose distribution as we expected. In conclusion, PC-based 3-D stereotactic localization system was developed to determine the stereotactic coordinate of the target. A convenient technique for the small field measurement was demonstrated. Those methods will be much helpful for the stereotactic radiosurgery.

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Studies on the Cackroach Distribution from the House in Seoul City Area (서울시내(市內) 가주성(家住性) "바퀴"의 분포(分布)에 관(關)한 조사(調査))

  • Cha, C.W.;Ham, K.S.;Ahn, S.K.;Park, D.W.;Koo, S.H.;Han, Y.I.
    • Journal of Preventive Medicine and Public Health
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    • v.2 no.1
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    • pp.77-80
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    • 1969
  • In the cities nowadays, the dwelling conditions of Cackroach are provided by use of various kinds of construction material, installation of heating and cooling facilities that maintain moderate temperature, filthy sanitation, and lack of knowledge about insect as mechanical Vector. Cakroach is infectious disease Vector, and it proves to be of much importance in the public health. Considering such importance, the author has surveyed the distribution of Cackroach in the housing areas of Seoul City from May 1969 to the end of August 1969, and has come to the following conclusion: 1. House dwelling Cackroach collected in the City of Seoul are of two species, i. e. Blatella Germanica Linneaus and Periplaneta Japonica Karny. 2. Most of cackroach collected in Seoul are Blatella Germanica Linneaus and they are distributed in whole area of Seoul while that of Periplaneta Japonica Karny is distributed only in the limited area. 3. Dwelling places of Blatella Germanica Lineaus are in grog shop, Korean food restaurants, bakery shops, and patient rooms in hospitals. Many of them are found in tile kitchens and dining rooms of restaurants, and tearooms. They live in groups at older houses with much crack, warm and humid places. 4. For method of collection, the hand collection was the most effective. In trap collection during the day time, when the trap is placed at the narrow corners off the ground after confirming the dwelling places of cackroach, the match trap was more effective than the flask trap in collecting. In case of collecting during the night time, the flask trap was much more effective method than the match trap.

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A CLINICAL STUDY ON SKELETAL ANCHORAGE SYSTEM USING MINISCREW (구내고정원을 이용한 교정 치료중 miniscrew 탈락에 관한 연구)

  • Woo, Soon-Seop;Jeong, Soon-Tai;Huh, Young-Sung;Hwang, Kyung-Gyun;Yoo, Im-Hag;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.102-107
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    • 2003
  • At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

Review of 2011 Major Medical Decisions (2011년 주요 의료 판결 분석)

  • Yoo, Hyun-Jung;Seo, Young-Hyun;Lee, Jung-Sun;Lee, Dong-Pil
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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