• 제목/요약/키워드: Patient guideline

검색결과 311건 처리시간 0.027초

구강관리 프로토콜 적용이 항암화학요법을 받는 혈액암 환자의 구내염에 미치는 영향 (Effects of Oral Care Protocol on Oral Mucositis in Hematologic Malignancy Patients Receiving Chemotherapy)

  • 박수진;차경숙;김형선;박은영
    • 임상간호연구
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    • 제22권1호
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    • pp.1-9
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    • 2016
  • Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

Recipient vessel selection for head and neck reconstruction: A 30-year experience in a single institution

  • Chung, Jae-Ho;Kim, Ki-Jae;Jung, Kwang-Yoon;Baek, Seung-Kuk;Park, Seung-Ha;Yoon, Eul-Sik
    • 대한두개안면성형외과학회지
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    • 제21권5호
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    • pp.269-275
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    • 2020
  • Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient's demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n=107), followed by the anterolateral thigh flap (n=18) and fibula flap (n=10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion: Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.

개인정보 보호를 위한 의료영상 복사발급 지침에 대한 고찰 (Study for Guideline of CD copy Issue to Secure Personal Information)

  • 이종웅;강지연;김은정
    • 대한디지털의료영상학회논문지
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    • 제10권2호
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    • pp.11-16
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    • 2008
  • Images of medical treatment on PACS environment are digitized and they make saving and transmission of patient's information easy with CD format causing increase of patients transfer rate between hospital and data transmission as well. Figuring out the configuration of confining status of copied images of medical treatment with CD format and present the appropriate way of identification for personal information. 20 general hospital over 500 beds which are utilizing PACS currently. Questionnaire investigation focusing on PACS operation center and it's management people. In accordance with the law of securing personal information of public organizations, it says "Anyone who wants to see his or her information via representative he or she needs to make a letter of attorney and turn in this to the president of it's possessing facility" in the article 16. Based on the investigation of general hospital for CD copy issue status near metropolitan area, 8 out of 20, were issuing CD copy through personal identification process(the person oneself and representative) and 10 general hospital were doing by getting signature of receiptor only without identification of the person oneself and 2 general hospital confirmation process is not at all. By the law of securing personal information of public organization, article 16, confirmation process is supposed to mandate lawfully with a letter of attorney when there is any request of reading and/or copies of one's information. But in reality, there were no consistent rules on reading, the process and coverage of copy issue, rejection coverage of copy issue of CD copy in each general hospital PACS operation center. Therefore there is a big need for consolidated format which is applicable by law when the representative requests to issue of CD copy that is storing medical treatment images. By issue through this consolidated format, securing medical information of individual and systemic operation and management will be valid and effective.

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말기 류마티스성 발목관절염에 대한 인공관절 전치환술 및 항류마티스 약물 조절 후의 중기 추시 임상 결과 (Intermediate-Term Clinical Outcomes after Total Ankle Arthroplasty for End-Stage Rheumatoid Arthritis with Modification of Perioperative Anti-Rheumatic Medication)

  • 조병기;고반석
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.91-99
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    • 2019
  • Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.

12채널 해석 심전계 시제품 개발 (Development of a 12 Channel Interpretive Electrocardiograph)

  • 이병채;함건;전영일;최광철;최근호;김원기;김준수;정기삼;이정환;이명호
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.411-414
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    • 1997
  • This paper describes the design guideline, methodology and general specification of the developed 12 channel interpretive electrocardiograph. The developed 12 channel electrocardiograph consists of main module, patient module, DSP module, interface module, power/battery module, TFT color LCD and thermal recorder. The control panel of the system has full keyboard, rotate/push button, function key and unctional indicators. The graphic user interface program conveniently allows user to record, setup, store, manage ECGs. A variety of system configurations give it ability to make user favorable environment. This system also has a resting adult's ECG analysis program. The developed system and program will be continusely evolved using a database of clinically correlated ECGs.

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재조합 인체 혈소판 성장인자(rh PDGF)를 이용한 만성 창상의 치료 (Chronic Wound Treatment Using rh PDGF)

  • 정웅기;유대현;박병윤
    • Archives of Reconstructive Microsurgery
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    • 제11권2호
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    • pp.173-178
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    • 2002
  • Wound healing is the result of interaction of normal cellular and biochemical responses that restore the interrupted anatomical structure in limited period. When any response of them is impaired, it results in chronic wound. The factors that influence the wound healing process is not only limited to the fundamental disease of the individual but also the local factors, especially various growth factors secreted from the various cells involved in tissue regeneration have important role. Recent reports that the chronic wounds are depleted of these growth factors have led active studies on the alteration of local wound environment with manipulation of the growth factors and the its application in management of chronic wounds. We investigated the effect on the chronic wounds in 10 patients with various pathologic conditions to suggest the appropriate application and guideline of the indication. The chronic wounds resulting from various causes in 10 patients were treated with rhPDGF gel and good wound care. All the chronic wounds were located on the lower extremity and the average diameter was 2.5 cm. 7 patients were completely cured within 8 weeks, however the patient who received previous radiation therapy the healing was delayed to 14 weeks. Two patients with vascular ulcer were not cured with rhPDGF alone. Local application of rhPDGF has yielded complete cure of the chronic wound in 70% of the patients within 2 months. The author suggests that it would be an effective alternative treatment modality of chronic wound when it is applied with good wound care and appropriate indication.

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중재적 방사선 시술 시 환자선량에 대한 참고 준위 비교 (Reference levels for patient Radiation Dose in interventional radiological procedures)

  • 박혁;김용완;전주섭
    • 한국방사선학회논문지
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    • 제6권1호
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    • pp.11-17
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    • 2012
  • 중재적 방사선 시술 시 환자의 피폭선량을 시술별로 분류하여 측정 및 평가하여 안전관리 자료로 활용하고자 하였다. 검사는 시술별(TACE, EVAR, Iliac stent, Lower Limb, BAE, Embolization, PTBD, PTGBD, Abscess, Nephrostomy)로 투시시간, 면적선량, 영상획득이미지 수를 측정하였다. 시술별 분석결과 비혈관계 검사에서 전반적으로 낮은 값을 보였으며, 혈관계 검사에서는 IVC filter를 제외한 모든 검사에서 높은 값을 나타냈다. 투시시간은 EVAR가 24m30s로 가장 높았고, 면적선량 또한 EVAR가 236 $Gy/cm^2$로 가장 높았다. 면적선량률은 TACE가 22.8 $Gy/cm^2$로 높게 나타났다. 이 결과를 토대로 중재적 방사선시술시 환자피폭선량에 대한 기준선량을 제시하고자 한다.

The Feasibility of Short Term Prophylactic Antibiotics in Gastric Cancer Surgery

  • Lee, Jun-Suh;Lee, Han-Hong;Song, Kyo-Young;Park, Cho-Hyun;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • 제10권4호
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    • pp.206-211
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    • 2010
  • Purpose: Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. Materials and Methods: A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Results: Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Conclusions: Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.

Radiographic assessment of clinical root-crown ratios of permanent teeth in a healthy Korean population

  • Yun, Hee-Jung;Jeong, Jin-Sun;Pang, Nan-Sim;Kwon, Il-Keun;Jung, Bock-Young
    • The Journal of Advanced Prosthodontics
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    • 제6권3호
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    • pp.171-176
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    • 2014
  • PURPOSE. The aim of this study was to determine the absolute value of the root/crown ratio (R/C ratio) using panoramic radiographs (PRGs) in a healthy Korean population. MATERIALS AND METHODS. In total, 99 patient radiographs (of 50 males and 49 females subjects; aged 16 to 24 years old) were examined, and 2,770 teeth were analyzed. Crown lengths and root lengths were measured with modified Lind's measurements using PACS tools by two examiners in two separate sessions two months apart. All data were analyzed using SPSS. The independent t-test was used to assess for gender differences, and the paired t-test was used to compare both arches with a significance level of P<.05. RESULTS. The mean R/C ratios varied from 1.29 to 1.89 (male: 1.28-1.84; females: 1.31-1.94). The highest R/C ratios were recorded for the mandibular canines (1.89), followed by the maxillary canines (1.79). The lowest R/C ratios were recorded for the maxillary second molars (1.31). In comparison with the maxillary teeth (1.29-1.78), the mandibular teeth yielded the higher R/C ratio (1.47-1.89), and this difference was significant in the females (P<.05). The difference between the genders was not statistically significant, except for the maxillary central incisors, mandibular canines and mandibular first premolars. CONCLUSION. These data may enhance the understanding of the clinical R/C ratio as a useful guideline for determining the status of teeth and the ethnic difference.

사상체질 임상 연구 현황에 대한 조사연구;사상체질의학회지를 중심으로 (A Survey on the Sasang Constitution Clinical Study;In the Journal of Sasang Constitutional Medicine)

  • 이시우;황지호;유종향;오승윤;주종천;장은수
    • 사상체질의학회지
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    • 제20권2호
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    • pp.21-29
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    • 2008
  • 1. Objectives and Methods It has been examined 703 papers of Sasang Constitution Society published from 1989 to 2007. Among them, the study methods have been classified focused on 332 papers related to clinical research and the method of constitution diagnosis and subjects have been researched to research the reality of the clinical research of Sasang Constitutional Medicine. 2. Results 1. The rest studies are the most which can not be classified by existing study method among 332 clinical studies. 2. The study of patient control group is 17 cases and the clinical experiment is one case, so highly well-grounded studies have not been performed. 3. The most method of constitution diagnosis is the constitution diagnosis by experts and by QSCC. 4. The number of constitution diagnosis method performed in the research institution is within 2. They are 254 cases(89.5%). 5. The studies which utilize more than 3 constitution methods are 22 cases and the studies that use medical rash are 7cases(31.8) 6. The 215 cases that subjects are less than 100 are the most and 100${\sim}$500 subjects are 71 cases. 500${\sim}$10000 subjects are 33 cases and more than 1000 subjects are 15 cases. 3. Conclusions Therefore, it is needed to increase the rate of highly well-grounded studies and set the standard criteria by providing constitution diagnosis guideline.

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