• 제목/요약/키워드: Tree Hospital

검색결과 258건 처리시간 0.034초

효과적인 산전관리를 위한 고객관계관리(CRM)의 도입 (The Application of Customer Relationship Management for the Effective Prenatal Care)

  • 신숙;백수경;강성홍;김유미
    • 한국병원경영학회지
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    • 제10권1호
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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외상성 기관-기관지 손상의 진단 방법 (Diagnostic Methods of Traumatic Tracheobronchial Injury)

  • 손신아;조석기;도영우;이홍규;이응배
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.675-680
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    • 2010
  • 배경: 이 연구는 외상성 기관-기관지 손상의 특징적인 임상 증상 및 영상학적 소견 등에 대하여 알아보고자 하였다. 대상 및 방법: 2003년 1월부터 2009년 12월까지 본원 응급실을 통해서 내원한 외상 환자들 중에서 수술을 통해서 외상성 기관-기관지 손상으로 진단된 6명의 환자를 대상으로 하였다. 외상의 종류, 동반된 손상, 진단 방법 및 수술까지 걸린 시간, 수술 소견 및 수술 방법, 예후 등에 대해서 조사해 보고 후향적으로 진단에 중요한 인자 등을 알아 보았다. 결과: 손상의 원인으로는 교통사고가 1명, 낙상 및 흉부에 강한 압박을 받은 경우가 5명이었다. 주 증상으로 피하기종, 호흡 곤란, 통증 등이 있었으며 영상소견으로는 기흉, 종격동 기종, 혈흉, 늑골 골절, 폐좌상 등이 있었다. 기관지 내시경을 시행하지 않은 상태에서 2명에서는 흉부 CT 소견에서 기관-기관지 손상이 의심되었지만 나머지 4명에서는 의심하지 못했다. 수상 부위는 기관부위가 2예, 기관지가 4예 있었다. 수술은 개흉술을 통한 일차 문합을 시행하였고 수술 후 사망과 문합 부위 유출은 없었으며 1명에서 술 후 성대 마비가 있었다. 진단에 도움이 되는 특징적인 소견으로는 흉관 삽입 후 음압의 적용에도 불구하고 지속적인 심한 폐 허탈이 가장 중요한 소견이었으며, 흉부 CT에서의 기관-기관지의 주행 경로의 단절이 진단에 중요하였다. 결론: 외상성 기관-기관지 손상은 의심하지 않으면 진단이 쉽지 않으나, 특징적인 흉관 삽입 후의 임상 증상과 영상 소견은 진단에 큰 도움을 주었다.

하악 제3대구치 발치의 결정에 관한 재고찰 - 발치 현황과 영향 인자를 중심으로 (Reconsideration of decision making for third molar extraction)

  • 박원서;김진학;강상훈;김문기;김봉철;최지욱;이상휘
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권5호
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    • pp.343-348
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    • 2011
  • Introduction: Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third molars in the dental hospital of a dental college. Materials and Methods: 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars. Results: The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes Conclusion: The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful attention would be desirable to consider the risks and benefits of lower third molar extraction.

퇴원손상심층조사 자료를 기반으로 한 급성심근경색환자 재원일수의 중증도 보정 모형 개발 (Severity-Adjusted LOS Model of AMI patients based on the Korean National Hospital Discharge in-depth Injury Survey Data)

  • 김원중;김성수;김은주;강성홍
    • 한국산학기술학회논문지
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    • 제14권10호
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    • pp.4910-4918
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    • 2013
  • 본 연구는 급성심근경색환자의 효율적인 재원일수 관리를 위해 재원일수에 대한 중증도 보정 모형을 개발하고자 하였다. 2004-2009년 퇴원손상심층조사 자료에서 주진단이 I21인 급성심근경색환자 6,074명을 추출하였으며, 모형 개발 시 데이터마이닝 기법(다중회귀분석, 의사결정나무, 신경망 기법)을 적용하였다. 개발된 모형들 중에서 의사결정나무 모형이 가장 우수한 모형으로 판정되어 이를 본 연구의 중증도 보정 모형으로 채택하였다. 급성심근경색 환자의 재원일수의 중증도 보정에 영향을 미치는 주요한 요인은 관상동맥우회술 시행유무, 퇴원 시 사망유무, 동반지수 등 이였으며, 병상규모와 의료기관 소재지 별로 중증도 보정 재원일수와 실제 재원일수에 차이가 있었다. 급성심근경색환자의 재원일수 변이를 줄이고 효율적으로 관리하기 위해서는 개발된 모형에 각 의료기관의 자료를 적용하여 중증도를 보정한 후, 차이가 나는 요인을 규명하여 이를 해결하는 활동이 수행되어야 할 것이다.

Molecular Description of Macroorchis spinulosus (Digenea: Nanophyetidae) Based on ITS1 Sequences

  • Won, Eun Jeong;Kim, Deok-Gyu;Cho, Jaeeun;Jung, Bong-Kwang;Kim, Min-Jae;Yun, Yong Woon;Chai, Jong-Yil;Ryang, Dong Wook
    • Parasites, Hosts and Diseases
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    • 제54권1호
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    • pp.109-112
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    • 2016
  • We performed a molecular genetic study on the sequences of 18S ribosomal RNA (ITS1 region) gene in 4-day-old adult worms of Macroorchis spinulosus recovered in mice experimentally infected with metacercariae from crayfish in Jeollanam-do Province, Korea. The metacercariae were round, $180{\mu}m$ in average diameter, encysted with 2 layers of thick walls, but the stylet on the oral sucker was not clearly seen. The adult flukes were oval shape, and $760-820{\mu}m$ long and $320-450{\mu}m$ wide, with anterolateral location of 2 large testes. The phylogenetic tree based on ITS1 sequences of 6 M. spinulosus samples showed their distinguished position from other trematode species in GenBank. The most closely resembled group was Paragonimus spp. which also take crayfish or crabs as the second intermediate host. The present study is the first molecular characterization of M. spinulosus and provided a basis for further phylogenetic studies to compare with other trematode fauna in Korea.

Alveolar Cleft Reconstruction Using Chin Bone and Autogenous Tooth Bone Graft Material: Reports of 5 Cases

  • Jeong, Kyung-In;Lee, Junho;Kim, Kyung-Wook;Um, In-Woong;Hara, Shingo;Mitsugi, Masaharu;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • 제6권1호
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    • pp.13-21
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    • 2013
  • Purpose: To report the successful results of using chin bone graft and autogenous tooth bone graft material (AutoBT) in alveolar cleft patients. Materials and Methods: Five patients with alveolar cleft defects underwent alveolar bone grafting. Three patients were treated using chin bone graft, and the other two patients underwent AutoBT graft. After implant site development using chin bone graft in the fi rst three cases, endosseous implant restorations were placed. In case #4 and 5, AutoBT graft material was placed to guide the normal eruption of partially impacted maxillary right canine and to the upper docking site after distraction osteogenesis. Result: Successful implant restorations with closure of the oronasal fistula were achieved in alveolar cleft defect reconstruction using either chin bone graft (Case #1, 2, 3) or AutoBT graft material (Case #4, 5). Case #4 showed enlarged follicle of the right maxillary canine, indicating a normal eruption guide pattern. Conclusion: Both chin bone graft and AutoBT graft showed favorable outcomes in reconstructing alveolar cleft defects. Autogenous tooth bone graft opens up the possibility of avoiding harvesting autogenous bone graft with complications and morbidities.

위암 환자의 위 절제수술 후 한의학과 대체요법 사용실태 - 지방소재 일개병원의 경험 - (Korean Medicine, Complementary and Alternative Medicines (CAM) Therapy after Gastrectomy of Gastric Cancer in a Hospital)

  • 김찬영;양두현;강준원;황의형
    • 대한한의학회지
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    • 제28권3호통권71호
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    • pp.86-99
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    • 2007
  • Objectives : Cancer patients who are afraid of unpleasant therapy and doubt a perfect cure often seek out traditional Korean medicine or many other kinds of complementary and alterative medicine (CAM) instead. This study was carried out in order to learn the prevalence and kinds of the traditional Korean medicine and CAM to evaluate awareness of and attitude toward it. Methods : 213 patients with gastric cancer who had undergone surgery in the department of gastrointestinal surgery and visited for routine follow-up from November to December of 2004 were included. A questionnaire survey was done by trained interviewers for CAM and demographic information. Results : 96.7% of patients had experience with CAM. The kinds and frequencies of CAM were diet and nutrition 21.0%, folk remedy 21.0%, pharmacological treatment 13.5%, oriental medicine 5.3% and mind-body intervention 1.4%. 56.8% of patients had experienced 2-6 kinds of CAM, 37.4% more than 7. Among diet and nutrition, ginseng (62.9%) was highest, followed by ox leg bone soup (50.8%) and pumpkin (31.5%). Among the folk remedies, elm tree was highest at 46.5%, followed by phellinus linteus (Sang-Whang) at 26.8% and ganoderma lucidum (Young-Gee) 20.7%.satisfaction with CAM was relatively low (43.2%), many patients (78.2%) replied that they would use it continuously. Conclusion : Most patients had experience with many kinds of CAM, but didn't discuss it with medical doctors. If scientific study proves whether or not each kind of CAM is actually effective ondisease, it will help to improve the health of patients and prevent the inappropriate usage and cost.

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전기치료가 발통점 비활성화에 미치는 효과 (Effects of Electrotherapy on the Deactivation of Trigger points)

  • 정호발;방상분
    • 대한물리치료과학회지
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    • 제9권2호
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    • pp.123-131
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    • 2002
  • The purpose of this study is to compare Ultra Sound(U-S), Silver Spike Point(SSP) and Electro-Acupuncture(E-A) with each other and to objectively analyze their concrete validities and their effects on the deactivation of trigger points in patients with myofascial pain syndrome, and to provide basic necessary principles for clinical therapists. Sixty patients were randomly distributed into three groups of twenty persons each and the U-S, the SSP and the E-A were applied to each group respectively. Tree pain evaluation methods of VAS(Visual Analogue Scale), Electrical Stimulation Scale and Pressure Algometer were adopted to measure the effectiveness of each therapy. The results were as follows: The U-S and E-A groups demonstrated statistically significant decrease on the VAS. The pain thresholds by Electrical Stimulation Scale method was increased for all the groups of U-S, SSP and E-A with no statistical significance. however, Pressure Algometer method was found to increase the pain thresholds for both SSP and E-A groups with statistically significance. Statistically significant improvement was found for all the groups together after the administration of the U-S, the SSP and the E-A. From the above results, three methods of U-S, SSP and E-A are found to be effective tools for the deactivation of trigger points in patients with upper trapezius muscle of Myofascial Pain Syndrome. The E-A method was found to be the most effective among three methods.

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병원 옥상정원의 이용후 평가 - 서울아산병원을 대상으로 - (The Post-occupancy Evaluation of Roofgarden at Hospital - A Case Study of Asan Medical Center -)

  • 김인혜;허근영;최아현;김유일
    • 한국조경학회지
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    • 제31권5호
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    • pp.58-72
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    • 2003
  • Rooftop greenery has been used as a way to solve urban environmental problems by creating green space in densely populated cities. This study was carried out to suggest more effective designs for roof-garden at hospitals through a post-occupancy evaluation. The roofgarden of Asan Medical Center was evaluated with regards to setting, proximate environmental context, users, and design activity by a multi-method including plan investigations, observations, in-depth interviews and questionnaires. The results are summarized as follows; the users' main activities included resting, walking, and talking. A number of users were observed at shaded spaces sitting on such things as benches, pergolas, and shelters. The satisfaction of the users showed high satisfaction level except in the amount of shade, facilities, and shelter. The variables affecting a overall satisfaction were ‘accessibility’, ‘safety’, ‘quality of surroundings’, and ‘suitability for speculation’. By comparing the design concept with using pattern, designer's intention was not reflected sufficiently in several aspects such as ‘event deck for therapy programs’, ‘grove and path’, and ‘low planters’. This study suggests some design implications; it is necessary to furnish shaded sitting places for passive behaviors and pathways for walking or a light exercise. A wind-break wall with glass windows could widen the users' views in a limited space. Natural shade like tree shade or pergola are more desirable than artificial shades. As for the vertical location of the roofgarden, the middle floor could be better than top area for accessibility. Characteristics of building and users should be considered in detail to provide distinct spaces. Proper technical standards for the greening of artificial ground should be established.

Seasonal distribution of airborne pollen in Ulsan, Korea in 2009-2010

  • Choi, Seung-Hyeok;Jung, In-Yong;Kim, Dong-Yeop;Kim, Yang-Ho;Lee, Ji-Ho;Oh, In-Bo;Choi, Kee-Ryong
    • Journal of Ecology and Environment
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    • 제34권4호
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    • pp.371-379
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    • 2011
  • To determine the peak dispersal times of allergenic pollen grains in Ulsan, Korea, we performed continuous airborne pollen counts at three stations (Sts. A, B, and C) in Ulsan from August 2009 to November 2010. Pollen grains were sampled using a Durham sampler. Two peak pollen dispersal seasons were observed per year. The peak seasons generally coincided with the flowering period of anemophilous trees: Taxodiaceae (February), Alnus (March), Cupressaceae (April), Quercus, and Pinus (May), and with the flowering phase of herbs from August to November, e.g., Humulus, Artemisia, Gramineae, and Ambrosia from August through September. The highest concentration of airborne pollen was from Pinus (68%), followed by Quercus (15%), Alnus (6%), and Humulus (2%); whereas very low pollen concentrations were from Taxodiaceae, Cupressaceae, Artemisia, Gramineae, and Ambrosia (${\leq}$ 1% of the annual total airborne pollen concentration). Our findings indicate that Alnus and Humulus pollen are major allergens whereas those of Pinus and Quercus are minor allergens. The concentration of Alnus pollen grains at St. C was over five times that at Sts. A and B. This finding implies that individuals living at or near St. C are exposed to high concentrations of Alnus pollen before and after March, which is the flowering period of the alder tree. From August to September, individuals living at or near St. B are exposed to high concentrations of Humulus pollen. Our study suggests that Alnus pollen may be the major aeroallergen causing pollinosis in the spring at St. C and Humulus pollen may be the major aeroallergen in autumn at St. B.