• 제목/요약/키워드: physicians in Korea

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국소 스테로이드 주사 후에 발생한 장무지신건 파열 (Extensor Pollicis Longus Tendon Rupture Following Local Steroid Injection)

  • 최윤석;김태형;임진수;전영준
    • Archives of Plastic Surgery
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    • 제33권1호
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    • pp.120-123
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    • 2006
  • Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

토양특성 기반 토양수분 함량 예측을 위한 PTF 적용성 검정 (Verification on PTF (Pedo-Transfer Function) estimating soil water retention based on soil properties)

  • 허승오;손연규;현병근;신국식;오택근;김정규
    • 농업과학연구
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    • 제41권4호
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    • pp.391-398
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    • 2014
  • Identifying soil water content as a major factor for evaluating irrigation and water resource is a primary module to develop a prediction model. A variety of PTFs (Pedo-Transfer Functions) are applied in the models to estimate soil water content, the analysis techniques, however, which compare the estimated from models and the measured by instruments, are not reached at the level to demonstrate the effectiveness of the PTFs in Korea. Many soil physicians such as Eom, Peterson, Rawls, Saxton, Bruand, Baties, Tomasella & Hodnett (T&H), and Minasny, have developed analytic models using PTFs. Soil data for the analysis used soil water contents on 347 soil series (10 kPa), 358 soil series (33 kPa), 356 soil series (1,500 kPa) established by NAAS (National Academy of Agricultural Science). A coefficient of determination on soil water content at 10, 33 and 1,500 kPa was the highest as 0.5932 in EM (Eom model), 0.6744 in REM (Rawls model) and 0.6108 in REM, respectively. In conclusion, it is strongly suggested that the use of EM or REM is suitable for estimating soil water content in Korea although SM (Saxton model) has been widely used.

응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가? (Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims?)

  • 이경원
    • Journal of Trauma and Injury
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    • 제20권1호
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    • pp.19-25
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    • 2007
  • Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

Health Impact Assessment of Free Immunization Program in Jinju City, Korea

  • Kim, Keon-Yeop;Jeon, So-Youn;Jeon, Man-Joong;Lee, Kwon-Ho;Lee, Sok-Goo;Kim, Dong-Jin;Kang, Eun-Jeong;Bae, Sang-Geun;Kim, Jin-Hee
    • Journal of Preventive Medicine and Public Health
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    • 제45권4호
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    • pp.267-275
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    • 2012
  • Objectives: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. Methods: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. Results: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. Conclusions: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

A survey of patients' perspectives of steroid injection (ppyeojusa) in Korea

  • Shin, Bo-Mi;Hong, Sung Jun;Lim, Yun Hee;Jeong, Jae Hun;Moon, Ho Sik;Choi, Hey Ran;Park, Sun Kyung;Han, Richard Jin Woo;Kim, Jae Hun
    • The Korean Journal of Pain
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    • 제32권3호
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    • pp.187-195
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    • 2019
  • Background: Steroid injections are commonly used in pain clinics to relieve pain and treat inflammation. In Korea, these steroid injections are well known as 'ppyeojusa', which means to inject into the bone in Korean. Some patients often have a negative perception of this treatment method due to inaccurate information about the treatment and side effects of steroids. The purpose of this study is to investigate patients' perception and knowledge of ppyeojusa. Methods: A questionnaire about ppyeojusa was completed by patients who visited one of the pain clinics in nine university hospitals, from August 1 to September 10, 2017. Results: Three-hundred seventy-four patients completed the survey. Eighty-five percent of patients had had ppyeojusa, and 74% of the respondents had heard of ppyeojusa from the mass media, friends or relatives. Only 39% of the patients answered that this injection was safe without side effects if properly spaced. Of the patients surveyed, 21% responded that ppyeojusa are "injections into the bone"; while 15% responded that ppyeojusa are "terrible injections that melted 'the bone if used a lot'". Half of the patients did not know what the active constituent is in ppyeojusa. If steroid injections are advised by the pain specialists, 89% of the patients would consent. Conclusions: Most pain clinic patients have heard of ppyeojusa. Most patients obtained information about ppyeojusa from mass media, rather than their physicians. Therefore, it is likely that most patients have inaccurate knowledge.

An Open-Label, Multicentre, Observational, Post-Marketing Study to Monitor the Safety and Effectiveness of Umeclidinium/Vilanterol in Korean Patients

  • Eun-Yeong Cho;Jung-Eun Cho;Eun-Bin Lee;Seung Soo Yoo;Jung Hyun Chang
    • Tuberculosis and Respiratory Diseases
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    • 제86권1호
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    • pp.33-46
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    • 2023
  • Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period. Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 ㎍/25 ㎍) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician's evaluation (effective, ineffective/no change, worsening, indeterminable) and lung function improvement. Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment. Conclusion: This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.

한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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스마트 케어 시스템에서의 3차원 전립선 암 가시화 도구 개발 (Develop 3D Prostate Cancer Visualization Tool in Smart Care System)

  • 안병욱;신승원;최문형;정승은;김광기
    • 한국멀티미디어학회논문지
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    • 제19권2호
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    • pp.163-169
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    • 2016
  • In Korea, prostate cancer accounted for generating growth rate second the following thyroid cancer, because of western dietary habits. Survival rate of prostate cancer after clinical behavior is changed depend on follow-up management. A telemedicine have been applied to replacement of medical specialist in rural area, and a quick reaction to emergency situation. Our study developed prostate 3-dimensional (3D) visualization program and designed prostate aftercare system architecture, called smart care, using a device that can access the Internet. Region of interest (ROI) in prostate was manually segmented by physicians and visualized to 3D objects and sent to PACS Server as DICOM images. So, medical personnel could confirm patients' data along with 3D images not only PACS system, but also portable device like a smart phone. As a result, we conducted the aftercare service to 98 patients and visualize 3D prostate images. 3D images had advantage to instinctively apprehend where lesion is and make patients to understand state of their disease easily. In the future, should conduct an aftercare service to more patients, and will obtain numerical index through follow-up study to an accurate analysis.

The impact of an educational intervention on parents' decisions to vaccinate their <60-month-old children against influenza

  • Choi, Aery;Kim, Dong Ho;Kim, Yun Kyung;Eun, Byung Wook;Jo, Dae Sun
    • Clinical and Experimental Pediatrics
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    • 제60권8호
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    • pp.254-260
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    • 2017
  • Purpose: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results: Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion: The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months.

국가대표 선수들의 훈련 기간 동안 발생한 스포츠 손상 분석 (Analysis of sports injuries among Korean national players during official training)

  • 김은국;김태규
    • Journal of the Korean Data and Information Science Society
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    • 제25권3호
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    • pp.555-565
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    • 2014
  • 본 연구에서는 엘리트 운동선수들이 국가대표 선수로써 공식적으로 수행한 훈련 기간 동안 발생한 스포츠 손상에 대해 종목별로 분석하였다. 국가대표 선수들을 진료하고 관리하는 의사, 물리치료사 및 종목별 트레이너들은 훈련도중 발생한 모든 스포츠 손상을 보고서 양식에 기록하였고, 이 중 기존에 이환되어 있는 만성 스포츠 손상을 제외한 급성 및 재발성 스포츠 손상들에 대해 분석하였다. 그 결과 1년간 총 3,421건의 스포츠 손상이 발생하였고, 이 중 1,560건은 급성 스포츠 손상, 1,861건은 재발성 급성 손상이었다. 남자 선수와 여자 선수에서 급성 스포츠 손상이 가장 많이 발생한 종목은 각각 복싱과 하키였다. 남자 선수와 여자 선수에서 재발성 급성 스포츠 손상이 가장 많이 발생한 종목은 각각 레슬링과 펜싱이었다. 또한 본 연구에서는 국가대표 선수들의 공식적인 훈련기간 동안 발생한 종목별 스포츠 손상과 관련된 특징 및 발생률 (incidence rates)에 대한 다양한 분석 결과를 포함하였다. 따라서 본 연구의 결과는 대한민국 국가대표 선수들의 훈련 중 발생하는 스포츠 손상 예방을 위한 프로그램 마련에 유용한 정보를 제공할 수 있을 것이다.