The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.
Recently, Practicing of ghost surgery and duty of informed consent of doctors have become a big issue in the medical dispute and lawsuits. The ground of admitting the informed consent and the agreement(self-determination of patients) can be based on the dignity of man and the right to pursue his happiness guaranteed under Article 10 of the constitution in theory. However there are no explicit legal regulations on the duty of the informed consent and there is no substantive legal enactment on the informed consent, but there is a collision between self-determination of patients and the discretionary power of doctors. If the discretionary power on the duty of the informed consent was extended it may result in the infringement of the right of surgical patients, so called arbitrary medical treatment. Relating to this issue, New Jersey Supreme Court held that a patient has the right to determine not only whether surgery is to be performed on him, but also who shall perform it. Moreover it held that a surgeon who operates without the patient's consent engages in the unauthorized touching of another and, thus, commits a battery'. But there are no ghost surgery cases adopting battery theory in Korea, and professional negligence has been considered rather than the battery, regarding an absence of hostile intent to injure patient. Supreme Court of Korea held that a doctor who operates a medical procedure without the patient's valid prior consent based on wrong diagnosis commits professional negligence resulting in injury, and the patient's invalid consent do not preclude wrongfulness'. However, if a health care provider conducts a completely non-consensual treatment or substitute surgeon without consent, the action should be plead in battery, not negligence, but if a health care provider violate his duty of care in obtaining the consent of the patient by failing to disclosure all relevant information (risks) that a reasonable person would deem significant in making a decision to have the procedure, the action should be plead in negligence, not battery. Therefore, the scope of patients' self-determination can be protected by stating clearly the scope of the duty of the informed consent and the exemption of the informed consent legislatively, it is considered that it is valid to legislate the limitation of the discretionary power.
This study intended to examine the health status and quality of life among the elderly patients who stayed in geriatric hospitals for a long period of time. The study involved 222 elderly who were older than 65-year-old, an oral examination was conducted in 10 geriatric hospitals located in the metropolitan area and Chungcheong-do. Cross-tabulation, one-way ANOVA, t-test, and Stepwise multiple regression were performed for analysis. The average number of teeth among the subjects was 11.22 and that of dental caries was 1.17. Also, the average number of teeth mobility was 0.93 and halitosis was detected among 81.9%. Only 29.70% reported absence or a kind of systemic disease and 70.31% of the subjects was shown to have more than two kinds of complex disease. In addition, 87.8% of the subjects had depression and among them, 55.40% showed serious depression. The average score on quality of life was 2.62 points and as for the related factors, the number of remaining teeth and dental caries were counted along with care grade, hospitalization period, and age. According to such results, the oral health status among the elderly patients staying long in geriatric hospitals were not good in general; also they showed high level of systemic disease and depression and low quality of life.
Journal of the Korea Academia-Industrial cooperation Society
/
v.10
no.9
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pp.2545-2550
/
2009
The purpose of this study was to examine the oral health care and oral health awareness of some laborers. Out of them, 220 workers were selected from K motor company in Hwaseong, and the other 180 workers were selected from D automobile company in Bupyeong. The findings of the study were as follows: As for daily toothbrushing frequency, the largest number of the laborers investigated(44.0%) brushed their teeth three times a day. Smoking made a significant difference to that($x^2$=19.00, p<.01). Concerning the use of oral hygiene supplies, 41.3 percent put oral hygiene supplies to use. There was a significant difference in that aspect according to gender($x^2$=9.20, p<.01). Regarding scaling experience, the largest group(37.3%) had their teeth scaled twice or more, and their scaling experience significantly varied with gender($x^2$=8.60, p<.05), age($x^2$=20.07, p<.01), academic credential($x^2$=11.88, p<.01) and the presence or absence of systemic diseases($x^2$=8.19, p<.05). In relation to oral diseases, the greatest group(27.8%) had dental caries. By gender, the female workers had more dental caries or the more swollen gums than the males, and the gap between the two was significant($x^2$=13.65, p<.05).
Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.
The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.
Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.
Hyun Ji Kang;Yookyung Kim;June Young Bae;Jung Hyun Chang;Soo-Hyun Lee
Journal of the Korean Society of Radiology
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v.82
no.4
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pp.903-913
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2021
Purpose To identify the imaging features indicative of sarcoid-like reactions in patients with intrathoracic lymphadenopathy after complete remission of malignancies. Materials and Methods This study enrolled five patients with histopathologically confirmed sarcoid-like reactions that developed after cancer remission. The clinical features and findings of CT and 18F-fluorodeoxyglucose (FDG) PET/CT were assessed. Results The underlying malignancies included breast, nasopharyngeal, colon, and endometrial cancer and lymphoma. The time intervals between complete remission of malignancy and the diagnosis of sarcoid-like reaction ranged from 6 to 78 months. CT findings of sarcoid-like reaction included bilateral hilar and mediastinal lymphadenopathies (n = 5), pulmonary nodules (1-15 mm) with peribronchovascular, fissural, or subpleural distribution, and interlobular interstitial thickening in the lungs (n = 4). 18F-FDG PET/CT revealed hypermetabolic uptake in the mediastinal and hilar lymph nodes and both lungs in the absence of extrathoracic uptake (n = 3). The sarcoid-like reactions resolved in all patients after corticosteroid treatment. Conclusion In patients with complete remission of malignancies, newly developed bilateral hilar and mediastinal lymphadenopathies with or without pulmonary nodules of perilymphatic distribution, in the absence of recurrence at the primary tumor site and extrathoracic metastasis, may suggest a sarcoid-like reaction. Such cases warrant histologic evaluation of the lymph nodes to prevent unnecessary systemic chemotherapy.
Purpose: In this study, we will try to find out problems and improvements of the policies in order to verify whether the plans contribute to the health and welfare of the firefighters properly. Method: By the Delphi analysis by experts. Result: There are problems such as absence of Firefighters' hospital, insufficient mental health education program in fire department, lack of on-site risk assessment system, problem on ineffectiveness of mental and physical health care business, lack of substantiality on mental and physical stability program, absence of mental health education, ensuring the confidentiality for users of mental health programs, lack of support for parent firefighters, lack of firefighters' retirement design and insufficient treatment for female firefighters. Conclusion: There are Improvements such as establishing Firefighters' hospital, improving mental health education and training CISD leaders in the fire department, preparing disaster risk assessment system, effectiveness measurement for visiting psychological counseling projects, improving the program through customer satisfaction surveys, establishment of mental health education system, ensuring confidentiality by improving personnel systems, encourage childcare leave and introduce childcare facilities at fire stations, revitalizing retirement Firefighters and policy development for female firefighters.
Park, Jung-Sun;Paek, Do-Myung;Lee, Ki-Beom;Rhee, Kyung-Yong;Yi, Kwan-Hyung
Journal of Preventive Medicine and Public Health
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v.27
no.3
s.47
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pp.475-486
/
1994
In order to provide necessary information for better health of workers through understanding the actual status of the industries adopting shift systems. The data were gathered from a stratified random sample of 347 (0.5%) firms selected out of about 70,000 manufacturing industries throughout the nation in 1993. Stratification during sampling was by industrial group and number of workers. The major findings obtained from 288 firms surveyed completely were as follows : 1. About 20.2% of the 288 firms were adopting shift systems and shirtworkers accounted for about 25.1% of the total work force in 288 firms. 2. The bigger number of workers was, the higher the adopting rate of shift system was. 3. The rate of having welfare facilities such as dining room, commuting bus, washing facilities, and health care room etc. was higher in the industries adopting shift systems. 4. The major industrial groups adopting shift systems were the rubber a: plastic goods manufacturing industry (54.1 per 100 firms) and the textile manufacturing industry (44.8 per 100 firms). However, the proportion of shiftworkers was higher in the textile manufacturing industry (70.5 per 100 firms) and the electronics industry (57.9 per 100 frms). 5. The most predominant work schedule was the weekly rotating, semi-continuos 2-crew 2-shift system (47.5%). 6. In the industries adopting shift systems, shiftworkers had an adjusted average of 0.29 spells per 100 workers ($0.14{\sim}0.45$ in 95% C.I.) compared to 0.23 spells per 100 nonshift dayworkers ($0.15{\sim}0.31$ in 95% C.I.) for 1 month. 7. Also, in the industries adopting shift systems, the adjusted average annuel turn-over rate of shiftworkers was 13.07 per 100 workers ($12.03{\sim}14.12$ in 95% C.I.) compared to 10.18 per 100 nonshift dayworkers ($9.53{\sim}10.82$ in 95% C.I.).
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