• Title/Summary/Keyword: Special hospital

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Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki;Cho, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.408-413
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    • 2012
  • Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

A Study on the Identification of Risk Factors for unplanned Readmissions in a University Hospital (계획되지 않은 재입원에 대한 위험요인분석)

  • Hwang Jeong Hae;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.201-212
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    • 2002
  • This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

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Body composition and hemodynamic changes in patients with special needs

  • Tsukamoto, Masanori;Hitosugi, Takashi;Esaki, Kanako;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.193-197
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    • 2016
  • Background: Some patients with special needs exhibit intellectual disability, including deficits in cognitive skills and decreased quality of life. The purpose of this study was to retrospectively compare changes in body composition and hemodynamics during general anesthesia in patients with and without special needs. Methods: The backgrounds of patients who underwent oral maxillofacial surgery under general anesthesia were recorded from medical records. Intracellular water (ICW), extracellular water (ECW), stroke volume variation (SVV), and heart rate (HR) were recorded for 3 h after the start of anesthesia. Categorical data were compared using an unpaired t-test, and a P-value of less than 0.05 was regarded as significant. Numerical data were compared using the Bonferroni correction, and a P-value of less than 0.0125 was regarded as significant. Results: A total of 21 patients were included in the study: 10 patients without special needs (non-S-group) and 11 patients with special needs (S-group). There were no significant differences in patients' backgrounds, except with regard to height (P = 0.03). In both groups, ICW and ECW were maintained, although they were lower in the S-group compared to the non-S-group. SVV was maintained in both groups, although it was higher in the S-group than the non-S-group. HR was significantly lower in the S-group 1 h after induction of anesthesia (P < 0.003). Conclusions: Changes in hemodynamics due to body fluid imbalance should be monitored during general anesthesia, especially for patients with special needs.

INTEGRATION OF CONSTRUCTION TECHNIQUES FOR SPECIAL ISOLATION WARDS OF HOSPITAL BUILDINGS

  • Chi-Su Tai ;Sy-Jye Guo
    • International conference on construction engineering and project management
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    • 2005.10a
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    • pp.627-632
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    • 2005
  • The severe acute respiratory syndrome -SARS virus spreaded rapidly in Asia in 2003 caused a lethal and serious epidemic. Establishing special isolation wards of high-level epidemic prevention has becomes one of the most important tasks of epidemic prevention. Taking the biosafety level of US CDC biology laboratory as an example, the laboratory of the highest level, BL4 and that of the second high level, BL3 are only allowed to handle and research this kind of highly dangerous viruses safely, to ensure the safety of researchers and the surrounding environment.This research aims to study the functions and the design requirements of "special isolation wards", which is equivalent to the high-level biotechnology laboratory, and have an integrated discussion about the design and construction techniques of this kind of wards, expecting to provide a reference for constructing special isolation wards and maintaining operation safely in Taiwan.

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A comparative analysis of the job stress of workers in general hospitals and special · specialized hospitals (일반병원과 특수 · 전문병원 종사자의 직무스트레스 비교 연구)

  • Kim, Dong-Hyeon;Kim, Nam-Song
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.8
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    • pp.3704-3714
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    • 2013
  • This work was intended to investigate types and characteristics of job stress in general hospitals and special hospitals, and thereby suggest the direction to perform stable employee management and stress alleviation program through the ways of overcoming stress depending on each characteristic of hospitals. In this study, 109 of professionals working in general hospitals and 117 working in specialized hospitals participated, and, as a measuring instrument, the 'Measuring Instrument of Korean Job Stressors' according to 'Standardization and Development of Korean Job Stress Questionnaire' made by Occupational Safety & Health Research Institute as part of a policy research project in 2004 was used. As a result, this work looked into stress characteristics appearing differently according to the environment and organizational system of general hospitals and special hospitals. Based on the study result, it is expected that this work will be used as a fundamental material to develop the program of overcoming stress on the basis of each hospital characteristic.

TREATMENT BARRIERS OF SPECIAL NEEDS PATIENTS - PART 1. CONSIDERATION FROM THE PERSPECTIVES OF SPECIAL CARE DENTISTS (장애인 구강진료 접근성 제약 - Part 1. 장애인 치과 의료진 측면에서의 고찰)

  • Chang, Juhea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.7-13
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    • 2019
  • The aim of this study was to clarify the barriers of dental treatment for special needs patients felt by dentists and to determine the dentist-related factors contributing to the obstacles in treatment planning and decision making. Questionnaires were distributed and responded by dentists working at five public-based special care clinics in South Korea. Factors divided into three parts (dentist demographics, clinical factors, and educational and administrational factors) were assessed and analyzed for correlations between dentist-related factors and dentist-felt burdens for special care treatment. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 34 dentists responded to the questionnaires. Almost all dentists had obstacles in the treatment of special needs patients in terms of the patients' lack of cooperation (94.1%), proxy communication with caregivers (94.1%), payment reward system (63.6%), deficient workforce (67.7%), and others. The longer dentists had been practicing for special needs patients, the more they were dissatisfied with the reward system and a longer time was spent for communication with patients and their caregivers (p<0.05). For specialists, more obstacles were experienced in treatment planning due to a deficiency in the clinical information obtained from their patients compared to general practitioners (p<0.05). A total of 82.4% of the respondents approved of mandatory educational programs for special care dentists. There were practitioner-based factors related to the amount of obstacles felt by special care dentists. To overcome the treatment barrier of special needs patients, in-depth education and training are required in special care dentistry.

A Case of Traditional Korean Medicine for a Patient with Fibromyalgia Experiencing Whole Body Pain and Sleep and Digestive Disorders (전신통 및 수면, 소화 장애를 동반한 섬유근육통 환자의 한방 치험 1례)

  • Choi, A-ryun;Jung, You-jin;Kang, Ah-hyun;Han, Dong-kun;Sung, Jae-yeon;Seo, Hye-jin;Lee, Hyung-chul;Eom, Gook-hyun;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.797-805
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    • 2017
  • Objectives: The purpose of this clinical case is to evaluate the efficacy of traditional Korean medicine as a treatment for fibromyalgia. Methods: The patient was treated with Korean medicine therapy (herbal medicine, acupuncture, pharmacopuncture, and Chu-na therapy). We measured the status and progress of this patient using a numerical rating scale (NRS), EuroQol-5D, range of movement (ROM), and a special test. Results: After the treatments, the patient's pain was controlled and the NRS score decreased. The overall symptoms of the patient and the EQ-5D score were both improved. The ROM and special test score were also improved. Conclusions: Traditional Korean medicine may have positive effects as a treatment for fibromyalgia.

A Study on Preparation for Reduction Factors of Health Insurance in the Latest Occupational Therapy (최근 작업치료(OT)의 의료보험 삭감요인에 대한 대처방안 연구)

  • Cho, Yun-Kyoung;Choi, Byung-Ok;Kim, Jong-Dae
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.226-235
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    • 2003
  • Under the present occupational therapy 6 items of overall coverage objects of health insurance are being applied and among them, only 3 items including the simple therapy, complex therapy, and special therapy can be demanded in the hospital. The treatment for Activities of Daily Living(ADL), Oral Motor Exercise and Functional Electrical Stimulation(FES) is exempted from an issue of reduction object, because it was covered 100% by the person himself. The reason why there are a lot of reduction factors is attributed mainly to vagueness of criteria and lack of exact understanding between therapists of insurance-applied hospitals. The reduction factors are characterized to confine them to only special treatment which demands the highest insurance cost claimed and to be applied without consideration of treatment times or days of hospital treatment. Moreover, the 56.38%, rate of reduction results from its uniform application based on willful convenience of health insurance not on embodiment of criteria or characteristics of various type of patients.

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