• Title/Summary/Keyword: 환자 만족

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CORRECTIVE RHINOPLASTY OF THE POST-TRAUMATIC RESIDUAL NASAL DEFORMITIES (외상성 비변형의 이차적 정비술)

  • Choung, Pill-Hoon;Kim, Chang-Soo;Chae, Yun-Pill;Ann, Heui-Young;Chung, Sang-Chul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.1-10
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    • 1989
  • The major causes of the facial bone fractures are fractures are automobile collision or other accident, and fights. Of the facial bone fractures, the nasal bone fractures are monst common. According to Schroeder et al., 50% of facial bone fractures are isolated fractures of the nasal pyramid. But the fractured nasal bone is not immediately treated as other facial bone fractures. And it is necessary to delay the treatment of the combined nasal bone fractures with other jaw bone fractures because of the difficult anesthetic techniques. Therefore there are many residual nasal deformities following a fracture; nasal hump, saddle nose and alar rim defect. Many authors have suggested the methods to correct the post-traumatic nasal deformities. We have treated several patients with several methods and this paper presents the operating methods and results.

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Development of a Smartphone Application for Clinical Decision Making of Medication Administration (투약적용의 임상적 의사결정을 위한 스마트폰 어플리케이션의 개발)

  • Kim, Myoung-Soo;Park, Jung-Ha;Kim, Sungmin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1650-1662
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    • 2014
  • This study aimed to develop smartphone application contents for the medication reconciliation of high-alert medications and to evaluate the satisfaction for this application. The xcode 4.5 and ios 6.1 SDK(software development kit) were used for constructing screen of the system. After implementation during 4 weeks, thirty five ICU(Intensive Care Unit) nurses were asked function related, contents related, and usage related satisfaction using 12 items. And differences of satisfaction according to the number of daily use and the frequency of use were evaluated. Data were analyzed using descriptive analysis, ANOVA with the SPSS 18.0. We developed the formula for drug dosage calculation, the alarming procedure, and the information of the high alert medication. In the satisfaction items, the mean score of 'This application is helpful to perform drug dosage calculation' was 3.14. However, 'I satisfy this application' was relatively low as 2.94. There were no differences in satisfaction according to the daily use and frequency of use. Based on the results of this study, more advanced smartphone application for medication reconciliation of high-alert medications will provide an important platform for patient safety.

Operative Treatment of Displaced Proximal Humerus Fractures with the Angular Stable Locking Compression Plate (각안정 잠김 압박 금속판을 이용한 전위된 근위 상완골 골절에 대한 수술적 치료)

  • Kim, Dong-Wook;Kim, Chong-Kwan;Jung, Sung-Won;Kim, Hyeon-Soo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.27-34
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    • 2011
  • Purpose: We examined the clinical and radiological outcomes for displaced proximal humerus fractures that were treated with a PHILOS angular stable plate. Materials and Method: Forty four patients who underwent surgery between March 2007 and February 2010 were included in this study. All the cases were followed up for an average of 12 months. All the patients were examined and interviewed using the Visual Analog Scale (VAS) score, the Constant score and standardized X-rays to check the neck-shaft angle (NSA) and the presence of medial support. Results: The average Visual Analog Scale score was 2.8 points and the average Constant score was 70.5 points. The average neck shaft angle was $122.5^{\circ}$ and this was statistically significant between the good result group and the poor result group. There were 36 cases of the presence of medial support and 8 cases of the absence of medial support and the difference was statistically significant. Complications such as fixation failure happened in 12 cases. Conclusion: PHILOS angular stable plate fixation as an operative treatment for displaced proximal humerus fractures is a good and reliable treatment option.

Surgical Correction of Total Anomalous Pulmonary Venous Connection without Total Circulatory Arrest (완전 순환 정지 없이 시행한 총 폐정맥 환류 이상의 수술 교정)

  • Han Won Kyung;Cho Joon Yong;Lee Jong Tae;Kim Kyu Tae;Chang Bong Hyun;Lee Eung Bae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.12-17
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    • 2006
  • Background: Circulatory arrest under deep hypothermia is an important auxiliary means for surgical correction of total anomalous pulmonary venous connection (TAPVC), However, cardiac operations under deep hypothermic circulatory arrest are associated with the risk of post-arrest neurologic abnormalities. The purpose of this study is to evaluate the results of the surgical correction of total anomalous pulmonary venous connection without the total circulatory arrest. Materiai and Method: Between April 2000 and October 2004, hospital records of 10 patients were reviewed retrospectively. Result: The locations for abnormal anatomical connections were supracardiac in 7 cases, cardiac in 1 case, and infracardiac in 2 cases. The mean cardiopulmonary bypass time and aorta cross clamp time were 116.8$\pm$40.7 and 69.5$\pm$24.1 minutes. There was no surgical mortality. Postoperative complications were post-repair pulmonary venous stenosis in 1 case, pneumonia in 1, pneumothorax in 1, wound infection in 1,and diaphragmatic paralysis in 1. All patients without pulmonary venous stenosis were in NYHA class I at mean follow-up of 16.6 months (3$\∼$49 months) Conclusion: We could obtain excellent results by repair without the total circulatory arrest for total anomalous pulmonary venous connection.

Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb (오픈소스 기반 수술항법장치의 하지 골절수술 응용검토)

  • Joung, Sanghyun;Park, Jaeyeong;Park, Chul-Woo;Oh, Chang-Wug;Park, Il Hyung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.5
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    • pp.497-503
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    • 2014
  • Minimally invasive intramedullary nail insertion or plate osteosynthesis has shown good results for the treatment of long bone fractures. However, directly seeing the fracture site is impossible; surgeons can only confirm bone fragments through a fluoroscopic imaging system. The narrow field of view of the equipment causes malalignment of the fracture reduction, and radiation exposure to medical staff is inevitable. This paper suggests two methods to solve these problems: surgical navigation using 3D models reconstructed from computed tomography (CT) images to show the real positions of bone fragments and estimating the rotational angle of proximal bone fragments from 2D fluoroscopic images. The suggested methods were implemented using open-source code or software and evaluated using a model bone. The registration error was about 2 mm with surgical navigation, and the rotation estimation software could discern differences of $2.5^{\circ}$ within a range of $15^{\circ}$ through a comparison with the image of a normal bone.

Usefulness of $^{99m}Tc-HMPAO$ SPECT in the Localization of the Epileptic focus in Temporal Lobe Epilepsy: Comparison with EEG, MRI and CT (측두엽성간질의 간질 병소 편측화에서 $^{99m}Tc-HMPAO$ SPECT의 유용성: 뇌파, 자기 공명 영상 및 전산화 단층 영상과의 비교)

  • Kim, Jong-Ho;Kim, Jong-Soon;Kim, Sang-Eun;Choi, Chang-Woon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Nam-Soo;Myung, Ho-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.17-26
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    • 1991
  • 뇌 혈류의 기능적 영상화는 간질병소의 국소화에 이용되고 있으며 측두엽성간질의 편측화에 여러가지 진단 방법이 이용되고 있으나 만족할만한 결과를 보이지 못하고 있다. 최근 PET또는 SPECT를 이용하여 측두엽성간질에서 발작 간에 측두엽 병소의 대사율 및 혈류의 감소가 나타나며, 이러한 소견은 발작 유발 병소의 편측화에 매우 유용할것이라는 보고들이 있다. 저자들은 측두엽성간질에서 간질 병소를 편측화 하는데에 $^{99m}Tc-HMPAO$ SPECT의 유용성을 평가 하고자 측두엽성간질 31예에서 발작 간의 $^{99m}Tc-HMPAO$ SPECT 소견, 뇌파, 자기 공명 영상 및 전산화 단층 소견을 비교하였다. SPECT 소견에 따른 나이, 병력 기간과 병발시 나이 등의 임상 지수 간에는 유의한 차이가 없었다. 31예의 환자중 23예에서(74.2%) 국소 뇌 혈류 감소를 보였으며 17예(54.8%)에서 측두엽에 관류 감소가 관찰 되었다. 비인두 뇌파 표준 뇌파는 24예(77.4%)에서 측두엽에 편측화를 보였으며 SPECT와 뇌파 양자가 모두 편측화된 경우 일치도는 8/12예 (66.7%) 였다. 16예에서 시행된 전산화 단층 영상은 모두 편측화를 보이지 못했으며 27예에서 시행된 자기 공명 영상에서는 단지 1예에서 편측화를 보였다. 이상의 결과로서 발작 간의 $^{99m}Tc-HMPAO$ SPECT는 측두엽성간질 병소의 편측화에 유용한 보조 검사로 생각된다.

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The Evaluation of Recovery Rate of Radioimmunoassay Using Certified Reference Material (CRM) (인증표준물질(CRM)을 이용한 방사면역측정법의 회수율 평가)

  • Choi, Sung Hee;Shin, Sun Young;Lim, So Hee;Hong, Mee Kyung;Noh, Gyeong Woon;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.158-162
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    • 2014
  • Purpose: Reference material (RM) is defined as material that is safe and homogeneous enough about specified characteristic that is made with a purpose of using test of measurement or nominal characteristic. Certified reference material (CRM), which is issued by authorized organization, is defined as reference material that provides characteristic value, link uncertainty and retroactivity. The purpose of this paper was to evaluate recovery of radioimmunoassay by Certified Reference Material enclosed with a certificate and therefore to enhance reliability of test. Materials and Methods: WHO certified reference material is purchased from NIBSC (National Institute for Biological Standard and Control, United Kingdom) and made of 3 levels that are C-1 (low concentration), C-2 (medium concentration) and C-3 (high concentration) and measured for kit at the Seoul National University Hospital. Recovery rate is evaluated after measurement at four different days. Results: Recovery rate results using WHO certified reference material are T4 90%, Ferritin 88%, PSA 94%, Prolactin 99%, AFP 94% and TSH 93%. Conclusion: A procedure that appropriate accuracy, precision, specificity, sensitivity, reproducibility, and validate on the subject of kit for radioimmunoassay is essential. Recovery rate assay as extraction efficiency of analysis process is percent about already measuring results of analysis result after all measuring process. This is very important assessment standards of performance evaluation of immunoassay kit. Recovery rate results of 6 type used WHO CRM are satisfactory to 88~99%. This demonstrates that the radioimmunoassay is a very accurate measurement, which is very effectively utilized in clinical practice.

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The Effects of Medical Service Qualities on Satisfaction, Relationship Quality, and Revisit Intent in Long Term Care Hospital an Elderly Out-patients (요양병원을 이용하는 노인에게 의료서비스품질이 환자만족, 관계품질 및 웹사이트 재이용의도에 미치는 영향)

  • Kim, Byung-Yong;Jeong, Myeong-Ae
    • Health Policy and Management
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    • v.22 no.2
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    • pp.183-206
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    • 2012
  • Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

PRE-ORTHODONTIC TREATMENT WITH MYOFUNCTIONAL APPLIANCE (근기능장치를 이용한 교정 전 치료)

  • Kim, Min-Soo;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.620-627
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    • 2005
  • The purposes of early orthodontic intervention are to correct obvious problems, to intercept developing problems and prevent them from becoming worse. Myofunctional influence on facial growth and the dentition change in muscle function and initiate morphologic variation in the normal configuration of the teeth and enhance an already existing malocclusion. Myofunctional therapy has been advocated since 1960's as the treatment for tongue thrust and other oral habits. Pre-orthodontic $TRAINER^{(R)}$ is introduced as functional device usable in children of mixed dentition to correct functional problems concerning soft tissue, tooth and skeleton. The most common cases to treat with Pre-orthodontic $TRAINER^{(R)}$ are lower anterior crowding, anterior open bite, Class II malocclusion and deep bite. Also, it can be used as correction of oral habits. Patients in this cases visited Department of Pediatric Dentistry, School of dentistry, Dankook University for orthodontic treatment. Pre-orthodontic treatment with Pre-orthodontic $TRAINER^{(R)}$ was carried out for correction of the oral habits.

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Association of the COMT Gene Polymorphism with the Risk of PCOS in Korean Women (한국인 여성에서 다낭성난소증후군의 발생 위험도와 Catechol-O-Methyltransferase 유전자 다형성과의 관련성에 관한 연구)

  • Lee, Ji Young;Cha, Yun Jeong;Hur, Seung Eun;Kwon, Han Sung;Lee, Sun-Joo;Sohn, In Sook;Kim, Soo Nyung;Seung, Yon A;Chung, Hye Won
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.2
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    • pp.97-104
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    • 2006
  • Objective: To investigate whether polymorphism of Catechol-O-methyltransferase(COMT) gene is associated with the risk of polycystic ovary syndrome (PCOS) in Korean women. Methods: One hundred and thirty-six PCOS patients and eighty four controls were enrolled. Blood samples were collected from the patients diagnosed according to the 2003 revised criteria of the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Age matched women with regular menstruation from same geographic region were recruited as control subject. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine all individuals' genotype. Results: In women with $COMT^{LL}$ genotype, there was decreased PCOS risk and this difference was statistically significant (OR 0.24, 95% CI 0.11~0.51). Conclusion: The results suggest that the $COMT^{LL}$ genetic polymorphism might be associated with PCOS risk in Korean women.