• Title/Summary/Keyword: 선택진료

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Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder (인지처리치료: 외상후 스트레스 장애의 일차 치료)

  • Jin-Hee, Choi;Hyung-Seok, So;Soonjo, Hwang;Ji-Woo, Suk;Hayun, Choi;Seung-Hoon, Lee;EunYoung, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.80-98
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    • 2022
  • Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

Importance and Influence in Factors of Selecting Dental Clinics in Some Regions (일부지역의 치과병·의원 선택요인의 중요도와 영향)

  • Chun, Ae-Jong;Lee, Ka-Yean
    • Journal of dental hygiene science
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    • v.10 no.1
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    • pp.45-54
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    • 2010
  • The purpose of this study was to offer the importance on factors of selecting dental institution according to general characteristics targeting general dental patients, and the information of having important influence upon choosing dental clinic and dental hospital. The survey was carried out from August 2009 to September. As a result of analyzing SAS(ver 9.1), the following conclusions were obtained. In the importance on factors of selecting dental institution according to general characteristics, it was thought to be important in convenience of movement or mobility such as distance, transportation, and parking convenience according to age level. According to final academic background, the importance in a factor of rumor in dental clinic was high(p < 0.05). According to job, the significant difference was shown in rumor of dentistry and parking convenience(p < 0.05). According to income, the factor in the appearance of training a medical specialist was indicated to be statistically higher in the group with over 5 million won than the group with under 2 million won(p < 0.05). Given seeing the distribution of opinion about dental hospitals (comparison with dental clinics), the excellence in the medical staff's ability was indicated to be the highest in all of the factor of influencing the use satisfaction(${\beta}=0.18$), the factor of influencing the recommendation level(${\beta}=0.21$), and the factor of influencing the re-use intention(OR=2.09).

An Investigation of Selection and Transfer Factors on the Admission of Rehabilitation Hospital (재활병원 입원 시 선택 및 전원 요인 조사)

  • Lee, Jae Hong;Kwon, Won An;Lee, Jin Hwan;Min, Dong Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2819-2827
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    • 2013
  • The purpose of his study was to analyze the environmental and the medical factors of prematurely discharged patients in a rehabilitation hospital. The subjects were 107 inpatients. The data were collected using self-report questionnaire and analyzed using the SPSS Win 19.0 program. In result, Firstly, general selection of hospitals was the 'Recommendation' 35.5%, Environmental dissatisfaction factors are Hospital facilities 37.4%. Hospital choice is the highest 'Acquaintances' 23.4%. Second, the lowest group about professionalism, kindness, and description of explanation on satisfaction in survey is group of care workers for the sick. The highest group is physical and occupational therapist. Third, the satisfaction regarding medical procedures of administrative work, waiting time and medical expenses is the highest normal. Hospital facilities in one of the highest factors in environmental dissatisfaction is can be considered as an element of patient departure because of not much number of nervous special hospitals. Medical dissatisfaction factors is the lowest satisfaction of care worker even if those spend much time. this is the focus leaving hospital. Therefore, factors care workers on service satisfaction and dissatisfaction in analysis and problem solving is considered that the need to find ways to improve the quality of service care workers.

Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report (타과와의 협진을 통한 다수치 결손을 동반한 성장기 환자의 보철 수복 증례)

  • Kwon, Kung-Rock;Paek, Janghyun;Lee, Hyun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.339-346
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    • 2013
  • In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly.

국가적 수준의 치과의사 역량을 위한 치과마취과학의 교육역량과 치과의사국가고시 제고

  • Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.1-9
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    • 2012
  • 치과마취학의 교육목표는 치과치료 시 적절한 환자평가와 함께 동통 및 불안을 관리하기 위한 약품선택과 치과치료를 위한 흡입법과 정맥주사를 이용한 의식하진정법과 언제, 어떻게, 어디로 전신마취를 의뢰하는지를 알아야 할 사항과 특히 의학적 병력을 가진 환자와 특별한 관리가 필요한 소아 노인 장애인의 전반적 이해와 치료 전 전신적 환자평가를 할 수 있는 능력과 치과진료 중 일어날 수 있는 의료적 응급 상황과 치과응급상황을 식별하고 인공소생술을 포함한 치과 치료 과정에서 발생할 수 있는 의학적 응급상황들에 적절한 관리를 할 수 있어야 한다. 치의학교육의 최소한의 질 보장을 위한 국가적 수준의 치과의사 역량체계를 구축함으로써 치의학교육의 질 향상을 위한 치과대학(원)의 변화를 자극하고, 치과의료와 의료인력의 질적 증진 및 치과의료행위의 최소수준을 보장하는데 있다. 하지만 현행 국가고시에 있어 치과마취과학은 구강외과 과목에 포함되어 위 기술한 치과마취과학의 교육목표를 달성하는 데 어려움이 있다. 그러므로 국가수준의 치의학교육의 질에 대해 제고하고 학교의 교육과정 변화와 개선에 적용하고 국시원의 새로운 과목의 도입과 실기시험을 통하여 치과마취과학의 교육목표를 달성하는 데 목적이 있다.

Radiation Therapy for Patients with Early-Stage Breast Carcinoma Treated with Breast-Conserving Surgery (조기 유방암에서 유방 보존술후 방사선 치료)

  • Shin, S.O.
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.274-284
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    • 1997
  • 조기 유방암에 대한 바람직한 치료는 유방의 형태를 최대한 보존하면서 악성 종양을 치료하는 것이다. 이러한 목적을 충분히 달성하기 위하여 최대한 조기에 유방암을 진단하고 미용상 종양 절제술에 적합한 환자를 선택하여 절제 범위를 최소화한 유방 보존술을 시행하며 수술 후 유방 전체에 대한 근치적인 방사선 치료를 적절히 시행하면 된다. 여러 연구에서 전통적인 치료법인 근치적 또는 변형 근치적 유방 절제술의 성적과 비교하여 차이가 없으므로 조기 유방암의 치료에는 이상적인 치료법으로 인정된다. 이와 병행하여 액와부 림프절 및 전신적인 재발에 대한 진단 및 예방을 위하여 액와 림프절에 대한 충분한 외과적인 처치와 병리학적인 검사를 시행하여 불필요한 방사선 치료로 인한 부작용을 최소화하여야 한다. 만약 전신적인 치료가 요구되는 경우에는 항암제 및 내분비 요법을 병행하여 재발을 억제해야 유방 보존술의 장점을 살릴 수 있다. 결론적으로 이 치료법이 조기 유방암 환자의 삶의 질을 개선시키면서 최상의 치료 효과를 얻기 위해서는 유관 진료 각과의 의료진이 유기적으로 협조하여 조기 진단률을 높히고, 유방 보존술 및 방사선 치료 과정에서 환자들에게 치료 결과에 대한 확신을 심어주도록 열심히 노력해야 된다. 또한 치료와 연관된 부작용이나 합병증을 최대한 줄여나가는 방향으로 치료 방법을 계속 보완 발전시키는 것이 매우 중요하며 아직도 발전의 여지가 많은 이 치료법이 조기 유방암의 이상적인 치료법으로 정착하기 위해서는 향후 다양한 임상적인 경험을 통한 더 많은 연구가 필요하리라 생각한다.

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A Study on XML Compress method for efficient integration and storing of XML-based Clinical Information (XML 기반의 통합 임상정보를 효율적으로 저장하기 위한 XML 압축 기법에 대한 연구)

  • Yu, Wee-Hyuk;Jeong, Jong-Il;Lee, Tae-Heon;Shin, Dong-Kyoo;Shin, Dong-Il
    • Proceedings of the Korea Information Processing Society Conference
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    • 2005.05a
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    • pp.71-74
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    • 2005
  • 임상정보 문서는 환자 진료기록뿐만 아니라 처방전, 개인적 유전자정보를 가지고 있다. 이러한 임상 정보 문서는 병원 시스템들간에 교환 및 공유함으로써 양질의 의료서비스를 제공할 수 있다. 이와 관련하여 임상정보의 통합을 위한 기존의 연구들은 각각 HL7 메시지를 XML 문서로 변환하고 XML 기반의 CDA 를 관계형 데이터베이스에 저장하는 연구가 진행되었다. 그러나 관계형 데이터베이스는 문서의 데이터 별 테이블 단위로 생성, 저장된다. 그러나 HL7 과 CDA 는 문서 중심의 XML 문서이기 때문에 관계형 데이터베이스에 저장 시 문서 별 많은 변이가 존재하여 테이블 증가를 갖는다. 따라서 비정규적인 구조에 적합한 데이터베이스를 선택하기 위해 XML 전용 데이터베이스와 관계형 데이터베이스 비교하고 효율적 저장을 위해 압축기법을 제시한다. 압축기법을 적용한 임상 정보 데이터베이스는 대용량 임상정보 문서의 크기를 압축함으로써 문서의 크기를 줄임으로써 데이터베이스의 효율적 저장을 향상시킨다.

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Technique for fabricating a mandibular suction denture with a plastic implant tray (임플란트용 플라스틱 트레이를 이용하여 하악 흡착의치를 제작하는 방법)

  • Lee, Ju-Hyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.36-42
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    • 2021
  • Even though implant overdentures are preferentially recommended to mandibular edentulous patients, many patients may select conventional complete dentures due to cost and general condition. Proper retention and stability of conventional complete dentures in patients with severe alveolar bone resorption is difficult to achieve. To overcome the limitations, mandibular suction dentures with the closed mouth impression technique have been used. However, the previous technique requires the Frame cut back tray, the Centric tray, and the Gnathometer M. This article introduces a technique for fabricating a mandibular suction denture with common dental materials.

Choices of Medical Services and Burden of Health Care Costs: Japanese Prohibition of Mixed Treatment in Health Care (의료서비스 선택과 비급여 의료비 부담: 일본 혼합진료금지제도 고찰)

  • Oh, Eun-Hwan
    • Health Policy and Management
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    • v.31 no.1
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    • pp.17-23
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    • 2021
  • With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

Maxillary complete denture rehabilitation in flabby tissue patient fabricated by no-pressure impression technique with individual tray replicated treatment denture through 3D printing: A case report (3D 프린팅으로 치료 의치를 복제한 개인 트레이를 이용한 무압 인상을 통해 제작한 flabby tissue 환자의 상악 총의치 수복 증례)

  • Hong, Jun-Pyo;Bae, Jung-Yoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.246-253
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    • 2022
  • Flabby tissue is not rare for denture wearers. Mucostatic impression technique is necessary due to compromised retention and stability of denture resulting from distortion of mobile flabby tissue. In this report, individual tray was fabricated by model-scanning and 3D printing treatment denture. And then, mucostatic impression for flabby tissue was obtained by using individual tray modified with window technique. Definitive denture was fabricated based on information of treatment denture including incisal pontic arrangement, jaw relationship and occlusion.