• Title/Summary/Keyword: physician's work

Search Result 54, Processing Time 0.021 seconds

Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity

  • Holtmann, Henrik;Spalthoff, Simon;Gellrich, Nils-Claudius;Handschel, Jorg;Lommen, Julian;Kubler, Norbert R.;Kruskemper, Gertrud;Rana, Majeed;Sander, Karoline
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.39
    • /
    • pp.26.1-26.10
    • /
    • 2017
  • Background: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. Method: The desire of patients for CRS (N = 410; 26%) has been acquired in this $D{\ddot{O}}SAK$ rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient's views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician's questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. Results: The patient's assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. Conclusion: The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients' needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.

A Study on the Establishment of Clinical Nurse Specialist (우리나라 전문간호사제도 개선방안에 관한 연구)

  • Byun, Young-Soon;Kim, Young-Im;Song, Mi-Sook
    • Research in Community and Public Health Nursing
    • /
    • v.5 no.2
    • /
    • pp.130-146
    • /
    • 1994
  • Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

  • PDF

Study on Telemedicine system in Medical Law (의료법상의 원격의료 제도에 관한 고찰)

  • Joung, Soon-Hyoung;Park, Jong-Ryeol
    • Journal of the Korea Society of Computer and Information
    • /
    • v.17 no.12
    • /
    • pp.241-249
    • /
    • 2012
  • The rapid development of the current information and communication brings big changes and progress in the health service delivery system. And it is becoming the worldwide trend increasingly. As the name of medical information, by more rapid, detail and more quickly to the patients and diagnosis of the disease it provides not only a high level of health care services but also hospitals and related institutions are making increase the efficiency of the work. Among them, the Telemedicine, that system has many advantage which can expect the shorten the waiting time and the uniform high level of medical, etc. without visiting medical institutions. Especially, the most advantage is it can increase the accessibility of information about extensive medical, without regard to the time and place. But this is the reality, which compared speed the development of modern science and technology with lack of operational regulations and mindset. Current in our Medical Law, it regulates the Telemedicine, but it has Institutional, facility, and environmental constraints. Because, there is no detailed legal relationship. And it takes that in terms of a special form called by a non-face-to-face contact with medical practice rather than the scene. Therefore, in this paper will find a way out to activate the Telemedicine by presupposes the development potential is infinite and find the legal issues and improvements.

A Research on The Pulse & Disease-patterns and Diagnostic Theory of Exogenous Febrile Disease in the "Sanghanjeonsaengjip(傷寒全生集)" ("상한전생집(傷寒全生集).변상한발열례(辨傷寒發熱例)" 등에 대한 연구(硏究))

  • Choi, Dong-Su;Sheen, Yeong-Il1
    • Journal of Korean Medical classics
    • /
    • v.23 no.4
    • /
    • pp.103-153
    • /
    • 2010
  • "Sanghanjeonsaengjip(傷寒全生集)" is a classic medical work, written by the outstanding physician Dohwa(陶華) in the Ming Dynasty. The characteristic of "SangHanJeonSaengJip" is that this book succeeded to the spirit of pattern identification and treatment of Treatise on Cold Damage Diseases, newly changed a table of contents by symptoms, and together with this indicated the prescriptions in accordance with diswase-pattern at "YujeunghwalInseo(類證活人書)", "Hwajegookbang(和劑局方)" etc. Also because this kept the existing ephedra decoction, cinnamom twig decoction, minor decoction of bupleurum, decoction for reinforcing middle-energizer and replenishing qi etc.'s name on and unlikely indicated the medicine composition, it caused confusion, but at the later ages "Euhakipmun(醫學入門)" the so-called 'Doci(陶氏)' was added to the prescription name, so we are able to distinguish. Together with this, this book dose not indicate the dosage of medicine and indicates the first, the second, and the third classes[上中下] below medicine. As this dose not mean the three grades of quality"good, fair, and poor[上中下] of "Shennong's Classic of Materia Medica" but expresses the sovereign medicinal as the first class[上], minister medicinal as the second class[中] and assistant and courier medicinal as the third class[下], doctors can voluntarily decide the dosage of medicine in accordance with the degree of disease. At this thesis, I single out ten chapters in contents of 2nd volume named Hyeong(亨) corresponding to the details, among "Sanghanjeonsaengjip(傷寒全生集)". I discussed superficial fever types of exogenous febrile disease in chapter 1, aversion to cold types of exogenous febrile disease in chapter 2, syndrome caused un-sufficient sweating in chapter 3, organic fever types of exogenous febrile disease in chapter 4, aversion to wind types of exogenous febrile disease in chapter 5, Tidal fever types of exogenous febrile disease in chapter 6, Alternative attacts of chills and fever in chapter 7, Dysphoria with smothery sensation in chapter 8, Fidgetiness of exogenous febrile disease in chapter 9, and Headache of exogenous febrile disease in chapter 10, and together with this I discussed, in detail, which influence the prescriptions which are listed on each chapter have caused on future generations In accordance with this, I think that the above-mentioned symptoms and prescriptions are important when I research cold damage and warm disease study. So I orderly research revision, annotation, rendering and an investigation.

A Phenomenological Study On the Characterization Experience of Middle-aged Woman using Mandala Arts Treatment (만다라 미술치료를 활용한 중년기 여성의 개성화 경험에 관한 현상학 연구)

  • Kim, Ki-Uk;Shin, Dong-Yeol
    • Industry Promotion Research
    • /
    • v.5 no.2
    • /
    • pp.33-40
    • /
    • 2020
  • When most middle-aged women live in a time when they have to take responsibility for their lives, they feel lonely when they realize that their experience of not expressing their feelings properly has ended up being left alone due to their own existence and loss. As the first step in conscious awareness of unconsciousness of middle-aged women through analytical psychology, we performed "Mandara" and "Nanhwa Mandara," which meet me inside. The intermediate stage can be divided into transition and work phase. The working phase, develops one's own advantages and unique strengths that meet the inner world of promoting and acting values, correctly looks at reality, corrects emotion perception and balance, and is self-contained, seed mandala, associative mandala. They performed the strong points of mandala, the free mandala, and the Western mandala. The results of the study showed that mandala art therapy was found in middle-aged women. First, Mandarin art therapy experience affects the physical, psychological and human relations aspects of middle-aged women. Second, middle-aged women's experience of individualization through mandala art therapy shows psychological reversals and affects positive thinking and self-effectiveness. This study was suitable for qualitative research that approached the essence through practical understanding and direct exploration of research participants, and it is meaningful to suggest that it is necessary to develop an art therapy program through various mediums considering the lack of art therapy research in middle-aged women and problems experienced by the physician.

Difference in Patient's Work of Breathing Between Pressure-Controlled Ventilation with Decelerating Flow and Volume-Controlled Ventilation with Constant Flow during Assisted Ventilation (보조환기양식으로서 감속형유량의 압력-조절환기와 일정형유량의 용적-조절환기에서 환자의 호흡일의 차이)

  • Kim, Ho-Cheol;Park, Sang-Jun;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
    • /
    • v.46 no.6
    • /
    • pp.803-810
    • /
    • 1999
  • Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

  • PDF

A Study on the life of Yoon Cho Chang(尹草窓) and Cho-Chang-Kyeul(草窓訣) (윤초창(尹草窓)의 생애(生涯)와 초창결(草窓訣)에 관(關) 연구(硏究))

  • Kim, Joon Tae;Yoon, Chang Yeul
    • Journal of Korean Medical classics
    • /
    • v.6
    • /
    • pp.189-227
    • /
    • 1993
  • I have studied life of Yoon-Dong-Li(尹東里), who applied Un-Ki(運氣) theory to medicine during Suk-Jong(肅宗) to Joong-Jo(正祖) in Yi-Dynasty and also studied his existing writings named ${\ll}$Cho-Chang-kyeol${\gg}$ (草窓訣). The referenced original work prints were based on 1980's print of Chung-Ku oriental medical society and National Central Library and The academy a korean studies possessed print. Studied with these books, I have concluded as follows. 1. Yoon-Dong-Li(尹東里) courtesy name is Ja-Mi(子美), pen name is Cho-Chang(草窓). He was born in 1705, Suk-Jong(肅宗) 31yrs, and died in 1784, Jeong-Jo(正祖) 8yrs in Yi-Dynasty. He had lineage of third-generationed-doctor and learned medicine from his uncle, Yoon-Woo-Kyo(尹雨敎). His father Yoon-Yi-Kyo(尹이敎) gaved him second influence. 2. Confucianal physician in Ming Dynasty You-Bu(劉溥) respected Ju-Ryeom-Kye(周溓溪), confucianist in Song-Dynasty and You-Bu(劉溥) does not removed grass in front of window (because in chinese, Cho-Charig(草窓) means grass in front of window), and named himself Cho-Chang(草窓). Yoon-Dong-Li(尹東里) followed this suit so called himself Cho-Chang (草窓). 3. The main contents of ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣), (運氣衍論) was written in 1725, when Yoon-Dong-Li(尹東里) was 21yrs old and printed in 1736. The other part of ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣), (用藥篇) was written in 1746. These two parts were not written in the satre time. The (運氣衍論) was written llyears earlier than (用藥). Two parts were combined another day and named (草窓訣). 4. Existing ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣) is transcribed printing with the con tent of "Five elements motion and the six kind of natural factors theory" (五運六氣設). Each edition is generally similar in content, but also has different points each other so naw we hardly finds a complete set of works. 5. ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣) is a first technical book which treats of Un-Ki(運氣) theory in korea. 6. The contents of (運氣衍論) of ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣) is mechanism of diease according to excess and insuffciency of five elements motion and six kinds of nalural faclors.and symploms and priscriptions, includes variated priscriptions. 7. Two parts in (運氣衍論) of ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣), 'Sang-tong' (相通) and 'Kak-Tong' (各通), threats of mochanisim of the disease according to five elements. with the principle of inter-promoting and inter-acting, in the change of ten heavenly stems and five elements motion. 8. In the (用藥篇) of ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣) describes priscription for clinical application according to Un-Ki(運氣) and also records about misuse of medicine. 9. In the ${\ll}$Cho-Chang-Kyeol${\gg}$ (草窓訣), most of priscription are common using one, which also found in ${\ll}$Dong-$\breve{U}$i-Bo-Garm${\gg}$ (東醫寶鑑) and there are few of priscriptions hy Yoon-Dong-Li(尹東里).

  • PDF

Clinical Contents Model for Laboratory Result Exchange (진단검사결과의 교환을 위한 임상콘텐츠모형 개발)

  • Ahn, Sun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.11 no.9
    • /
    • pp.3330-3335
    • /
    • 2010
  • Due to the acceleration of medical information age, the semantic interoperability of clinical information is rising up as a major issue. The laboratory results are known as the best significant area among clinical information to be required for exchanging and sharing. The aim of this research is to develop the clinical contents model for exchange laboratory results. This research was conducted from March 2008 to September 2008. Firstly, the method is to get the attributes and codes from LOINC which is one of the standard medical terminology system related to laboratory and the Reference Information Model(RIM) of Health Level 7(HL7). Secondly, the attributes from each work process around orders and reports of laboratory was analyzed. We evaluated the attributes whether they could be represented into the attributes contained in HL7's RIM. Thirdly, the prototype for hemoglobin case using the structure of clinical contents model and defined attribute. Fourthly, the face validity was done by one laboratory physician with four clinicians. The assessment contents were for the suitability involved in representation and exchange with proposed model. The results shows that the model corresponds with the aim of the research. Eventually the proposed model for the exchange of laboratory results could contributes to information interchange according to laboratory area for the future.

Developmental disability Diagnosis Assessment Systems Implementation using Multimedia Authorizing Tool (멀티미디어 저작도구를 이용한 발달장애 진단.평가 시스템 구현연구)

  • Byun, Sang-Hea;Lee, Jae-Hyun
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.3 no.1
    • /
    • pp.57-72
    • /
    • 2008
  • Serve and do so that graft together specialists' view application field of computer and developmental disability diagnosis estimation data to construct developmental disability diagnosis estimation system in this Paper and constructed developmental disability diagnosis estimation system. Developmental disability diagnosis estimation must supply information of specification area that specialists are having continuously. Developmental disability diagnosis estimation specialist system need multimedia data processing that is specialized little more for developmental disability classification diagnosis and decision-making and is atomized for this. Characteristic of developmental disability diagnosis estimation system that study in this paper can supply quick feedback about result, and can reduce mistake on recording and calculation as well as can shorten examination's enforcement time, and background of training is efficient system fairly in terms of nonprofessional who is not many can use easily. But, as well as when multimedia information that is essential data of system construction for developmental disability diagnosis estimation is having various kinds attribute and a person must achieve description about all developmental disability diagnosis estimation informations, great amount of work done is accompanied, technology about equal data can become different according to management. Because of these problems, applied search technology of contents base (Content-based) that search connection information by contents of edit target data for developmental disability diagnosis estimation data processing multimedia data processing technical development. In the meantime, typical access way for conversation style data processing to support fast image search, after draw special quality of data by N-dimension vector, store to database regarding this as value of N dimension and used data structure of Tree techniques to use index structure that search relevant data based on this costs. But, these are not coincided correctly in purpose of developmental disability diagnosis estimation because is developed focusing in application field that use data of low dimension such as original space DataBase or geography information system. Therefore, studied save structure and index mechanism of new way that support fast search to search bulky good physician data.

  • PDF

The Properties of Beam Intensity Scanner (BInS) for Dose Verification in Intensity Modulated Radiation Therapy (방사선 세기 조절 치료에서 선량을 규명하는 데 사용된 BlnS System의 특성)

  • 박영우;박광열;박경란;권오현;이명희;이병용;지영훈;김근묵
    • Progress in Medical Physics
    • /
    • v.15 no.1
    • /
    • pp.1-8
    • /
    • 2004
  • Patient dose verification is one of the most Important responsibilities of the physician in the treatment delivery of radiation therapy. For the task, it is necessary to use an accurate dosimeter that can verify the patient dose profile, and it is also necessary to determine the physical characteristics of beams used in intensity modulated radiation therapy (IMRT) The Beam Intensity Scanner (BInS) System is presented for the dosimetric verification of the two dimensional photon beam. The BInS has a scintillator, made of phosphor Terbium-doped Gadolinium Oxysulphide (Gd$_2$O$_2$S:Tb), to produce fluorescence from the irradiation of photon and electron beams. These fluoroscopic signals are collected and digitized by a digital video camera (DVC) and then processed by custom made software to express the relative dose profile in a 3 dimensional (3D) plot. As an application of the BInS, measurements related to IWRT are made and presented in this work. Using a static multileaf collimator (SMLC) technique, the intensity modulated beam (IMB) is delivered via a sequence of static portals made by controlled leaves. Thus, when static subfields are generated by a sequence of abutting portals, the penumbras and scattered photons of the delivered beams overlap in abutting field regions and this results in the creation of “hot spots”. Using the BInS, inter-step “hot spots” inherent in SMLC are measured and an empirical method to remove them is proposed. Another major MLC technique in IMRT, the dynamic multileaf collimator (DMLC) technique, has different characteristics from SMLC due to a different leaf operation mechanism during the irradiation of photon and electron beams. By using the BInS, the actual delivered doses by SMLC and DMLC techniques are measured and compared. Even if the planned dose to a target volume is equal in our experimental setting, the actual delivered dose by DMLC technique is measured to be larger by 14.8% than that by SMLC, and this is due to scattered photons and contaminant electrons at d$_{max}$.

  • PDF