• 생물정신의학
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• 제18권3호
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

• 인터넷정보학회논문지
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• 제19권5호
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• pp.97-105
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• 2018

In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.

• 대한임상독성학회지
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• 제4권1호
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• pp.32-43
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• 2006

Purpose: Toxic Exposure Surveillance System (TESS) is widely used for poisoning data collection and making a counterplan. But, there were few reports about poisoning data collection using TESS in Korea. The aim was to collect poisoning data using TESS report form and investigate the recognition of emergency physician about the necessity of TESS as preliminary survey. Methods: Retrospectively, we gathered data from hospital records about the patient who admitted hospital emergency room due to poisoning. Date were gathered by paper and/or web client system report form in patients recruited by ICD-10 codes Results: From Jun 2004 to May 2005,3,203 patients were enrolled in 30 hospitals and their mean age was $44.9{\pm}20.3years$ old(male: female = 1,565: 1,638). The most frequent site of exposure was their own residence (73.2%, 2,345/3,203) and most of reported patients were older than 20 years(89.7%, 2,871/3,203). Frequent substances involved in poisoning were medication(41.9%) and pesticide(33.3%). Intentional poisoning was 60.7%(1,954). In fatality, overall frequency was 5.1%(162/3,203) and the most frequent route of exposure was ingestion(96.3%, 156/162) and the most frequent substance was pesticide(85.2%, 138/ 162). Antidotes were administered in 202 patients(2-PAM, atropine, antivenin, N-acetylcystein, vitamin K, flumazenil, ethanol, methylene blue, naloxone, calcium compound). 19 of 20 emergency physicians agreed with necessity of TESS. Conclusion: Data collection using TESS report form showed preliminary poisoning events in Korea. Frequent poisoning substance were medication and pesticide. The fatality was mainly related with pesticide ingestion. Many doctors in emergency room recognized the necessity of TESS.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2008년도 하계종합학술대회
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• pp.1105-1106
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• 2008

In this paper we construct a portable storage device (USB memory) for personal health information management system which guarantees control of one's information. (1) Development of system for inquiry hospital visit history, check-up results, and medication details (2) Establishment of personal emergency information management system for rapid and accurate treatment by an authorized person in case of an emergency (3) Development of a health diary program in which individual patients can input and manage their health information such as blood pressure, blood sugar level, weight, and pulse that they measured.

• Annals of Clinical Neurophysiology
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• 제21권1호
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• pp.1-6
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• 2019

Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.

• Korean Circulation Journal
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• 제53권5호
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

• 간호행정학회지
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• 제3권2호
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• pp.123-136
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• 1997

The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

• 디지털융복합연구
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• 제11권8호
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• pp.293-302
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• 2013

지금까지의 병원의 DW(Data Warehouse)는 주로 원무중심의 데이터를 분석하는 용도로 사용되어 왔다. 하지만, 전자의무기록(Electronic Medical Record) 시스템이 구축되면서 원무중심의 기존의 DW와 달리 진료 기록과 영상 촬영 기록의 판독내용 등의 비정형 데이터도 환자의 진료 및 치료의 중요한 정보를 얻는데 매우 유익하게 활용될 수 있다. 따라서 본 논문에서는 지금까지 병원에서 활용되는 원무 중심의 DW(Medical DW)가 아닌 진료 중심의 DW(Clinical DW)의 구축의 필요성을 제기하였다. 또한 CDW가 실제로 어떤 부분에 어떻게 활용되는 지를 기술하였다. 마지막으로 병원의 실제 진료 데이터를 시소러스(Thesaurus)검색 방법을 사용하여 과거 이력에 따른 연관 상병 간의 상관관계를 도출하여 환자 조기치료의 기반을 마련하고자 한다.

• The Korean Journal of Pain
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• 제31권1호
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• pp.54-57
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• 2018

Burner or stinger syndrome is a rare sports injury caused by direct or indirect trauma during high-speed or contact sports mainly in young athletes. It affects peripheral nerves, plexus trunks or spinal nerve roots, causing paralysis, paresthesia and pain. We report the case of a 57-year-old male athlete suffering from burner syndrome related to a lumbar nerve root. He presented with prolonged pain and partial paralysis of the right leg after a skewed landing during the long jump. He was initially misdiagnosed since the first magnet resonance imaging was normal whereas electromyography showed denervation. The insurance company refused to pay damage claims. Partial recovery was achieved by pain medication and physiotherapy. Burner syndrome is an injury of physically active individuals of any age and may appear in the cervical and lumbar area. MRI may be normal due to the lack of complete nerve transection, but electromyography typically shows pathologic results.

• 동의신경정신과학회지
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• 제20권2호
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• pp.217-227
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• 2009

Objectives : Multiple sclerosis (MS) is a demyelination disease of central nervous system, presenting a various neurological disorders depending on the lesion. In the view of oriental medicine, MS is similar to Flaccidity-syndrome(痿證). Also, since MS is a chronic disease which repeats the recurrences with periods of remission of the symptoms in between, it may usually be accompanied by depression. However, the etiology, treatment, and cause of recurrence of MS remain unknown, and also, as the recurrences of MS have been repeated, disease burden has been accumulated, which aggravates disorder. This case of MS experienced depression after the patient had been diagnosed as bad consequence based on the past 5 times recurrences of multiple sclerosis. Methods : We saw the causes as vicera and bowels functional disorder which might have come from a poor diet. Thus, we diagnosed this case as dual deficiency of spleen and kidney(脾腎兩虛), stagnant qi transforming into fire(氣鬱化火) and liver-kidney deficiency(肝腎不足) and treated it with Herb medication, acupuncture therapy, and supportive therapy, making the patient better. Results : We have improved the patient's condition to the time before 5th recurrence. Conclusions : This result suggests that our oriental medical treatments was effective on multiple sclerosis with depression.