• 대한치과의사협회지
• /
• 제53권2호
• /
• pp.82-95
• /
• 2015

Background: Interest in medical malpractice claims and accidents is a day-to-day social issue to general public as well as medical personnel. Related laws and regulations already have been established, and institutions based on the laws and regulations also have been founded. However, in our dental community, interest and response to the issue seem insufficient. Methods: We searched four medical literature databases that are mainly cited in the medical community. Keywords including 'dental malpractice claims', 'patient safety' and 'medical accident' were used for the search. Among the selected literatures, we chose specific ones separately whose content is authentic and easily approachable. Results: Medical malpractice claims and accidents tend to increase around the world. As the cost or the difficulty level of surgery increases, the dispute rate also increases, which appears even more apparent in developed countries. Preventive measures to prevent the disputes and accidents are not significantly different. Three critical of them include relationship of doctor with patient, the informed consent and medical record. Conclusion: Tools for accident occurrence or communication improvement have been introduced. All of those cost time and money. However, education or professional request of liability insurance companies, self-education and provision of guidelines can be immediately implemented. To implement those, dentists' promotion at the regional or national level is imperative. rhBMP-2 is widely used at sinus augmentation, alveolar bone defect, and socket preservation.

• 한국의사학회지
• /
• 제30권2호
• /
• pp.133-143
• /
• 2017

Objectives : This paper summarizes results from review of 36 cases and medical records extracted from Yeoksimanpil, involving treatment of exogenous disease in the last Joseon dynasty, and considers significance of treatment protocols. Methods : About 130 medical records from Yeoksimanpil related to exogenous disease were reviewed, and 36 cases were extracted for closer investigation. The author examined the characteristics of exogenous diseases treated in Yeoksimanpil during the Joseon dynasty, employing Yi Suki's theory about exogenous febrile disease, and analyzed the theory from the viewpoint of epidemic febrile disease (溫病學). Results : The majority of exogenous diseases recorded in Yeoksimanpil include Sanghan (傷寒); Seo (暑); Ryeohwan (厲患); and Hongjin (紅疹). Sanghan was found to be prevalent among the exogenous diseases, but diseases caused by warmth and epidemic are recognized separately from Sanghan. Yi Suki's theory about exogenous febrile disease is similar to the basic theory of modern epidemic febrile disease, although his theory was developed independently during the last Joseon dynasty. Conclusions : Although some exogenous diseases in Yeoksimanpil were recognized separately, Yi Suki did not specify each feature nor did he focus on each symptom. Instead, the author's research suggests that Yi Suki was able to identify and treat a variety of various exogenous diseases due to his accumulation of medical knowledge and skill.

• 대한두경부종양학회지
• /
• 제29권2호
• /
• pp.41-47
• /
• 2013

Background : The purpose of this study is to review our experience with the variable applications of the facial artery muscolomucosal(FAMM) flap for oral cavity reconstruction following treatment for head and neck malignancies. Methods : We performed retrospect medical record review from January 2012 to June 2013. This flap technique was applied in 3 patients to reconstruct the defects of oral cavity induced by treatment for head and neck malignancies. Results : The defects and fibrosis occurred due to variable causes related to previous treatment for head and neck malignancies such as tumor resection and chemoradiation. Two patient suffered from defect on hard and soft palate and one patient suffered from trismus related to fibrotic scar band. We performed oral cavity reconstruction using FAMM flap even though these all patients had history of neck dissection surgery or radiation therapy. Conclusion : FAMM flap is an ideal option for reconstruction following treatment not only for primary tumor resection but also for defects induced by variable causes. Preoperative radiation and neck dissection surgery, which are previously considered as some challenges, are no longer contraindication in our cases.

• 대한간호학회지
• /
• 제34권1호
• /
• pp.72-80
• /
• 2004

Purpose: The purpose of this study was to evaluate the effect of a constipation reduction program for inpatients. Method: Subjects were selected in one medical ward of C University Hospital from May, 2001 to November, 2001. Twenty-nine subjects were assigned to an experimental group and 32 subjects to a control group. Data related to the frequency of defecation and to the length and amount of laxative drugs used was collected by a medical record review and data on the degree of constipation was obtained by a self-report using a constipation assessment scale. Results: More than 90% of the subjects admitted in the department of neurology and one third of total subjects presented with activity limitation and about one fourth of the subjects were fed with a nasogastric tube. There was a significant difference in the degree of constipation, frequency of defecation, and the length and amount of laxative drug use between the two groups. Conclusion: This program is effective in inpatient's constipation reduction. Further studies need to apply this program in various clinical environments and properly use this program in different clinical settings.

• Journal of Preventive Medicine and Public Health
• /
• 제24권3호
• /
• pp.356-362
• /
• 1991

This study was performed to identify the maternal risk factors for the low birth weight. During the period from February to June in 1991, the medical record review and questionnaire interview were conducted upon the 465 pregnant women who were admitted to and delivered a baby in 3 general hospitals and an obstetric hospital in Kwangju area. The health and other related information from women who bore the low birth weight infant was compared with those from women who bore the normal birth weight infant. The results obtained were as follows : 1. Maternal age, low body weight at term, illegitimate birth, and maintaining work activity during pregnancy were positively associated with low birth weight. 2. The positive association was revealed between low birth weight and the previous abortion, short gestational weeks, anemia, low maternal weight gain during pregnancy, the obstetric present illness and hypertension. 3. Some maternal working conditions were associated with low birth weight although statistically not significant. 4. In multivariate logistic regression analysis, gestational weeks and maternal weight gain during pregnancy were related with low birth weight.

• Korean Journal of Acupuncture
• /
• 제23권2호
• /
• pp.1-18
• /
• 2006

Objectives: The subject of this research is the catechism on medicine between the doctors of Joseon and Japan in the 18th century through Choson Delegation(朝鮮通信使 ). Methods: The author intended to review and analyze the contents of catechism related to Acupuncture and Moxibustion and determined the characteristics of Joseon and Japan ?s Acupuncture and Moxibustion. Results: At the time, Japanese doctors had a grasp on most theories of Acupuncture and Moxibustion and were very specialized clinically. They usually used filiform needles with various techniques, and already they had many different schools in practice. However, they wanted to know if their Acupuncture and Moxibustion skills were up to the international standard, especially to Joseon, whom they regarded as a country advanced in Acupuncture and Moxibustion. They wanted to com- pare and contrast their Acupuncture and Moxibustion with Joseon's. 18th century Joseon was high time for Acupuncture and Moxibustion. Various tools were used in surgery, and varieties of needles were used to stimulate acupuncture points. The development of tools evinces the precision of Joseon's Acupuncture and Moxibustion at the time. Also, comprehensive works such as DongUiBoGam(東醫寶鑑) and UiHaklpMun( 醫學入門) greatly influenced Acupuncture and Moxibustion. Because of this impact, it can be deduced that Acupuncture and Moxibustion emphasizing Jang(臟) and Bu(腑) organs and Internal Injury developed greatly. In addition, acupuncturist Holm(許任)'s fame continued from the 17th century into the 18th century, and his medical practice left a huge mark on not only Joseon but other eastern Asian countries as well. Conclusions: We found out the evidences that there were a lot of exchanges of acupuncture and moxibustion between Korea and Japan based of the Joseon TongShinSa (Emissary)'s record of catechism on medicine in the 18th century.

• 대한한방내과학회지
• /
• 제42권4호
• /
• pp.563-571
• /
• 2021

Objectives: This pilot study aimed to confirm the possibility of applying our design to the main study, a retrospective medical record analysis of the diseases which have most frequently been treated with collaborations of Korean and Western medicine, and to identify what corrections and statistical models are needed to conduct the main study. Methods: Data were collected from a case report form developed for patients who received treatment in the medical institutions. Appropriate statistical techniques, like Propensity Score (PS) and Generalized Estimation Equation (GEE) models, were used to compare the indicators of collaboration and non-collaboration groups for patients in comparable diseases. Results: Using PS matching for each M and S disease group, the indicators were compared by balancing the collaboration and non-collaboration group, and the GEE models compared indicators between groups in each disease over follow-up. Through this process we identified two limitations, insufficient samples and a large deviation of the follow-up period. Conclusion: This pilot study confirmed that the study design and case report form are applicable. The main study will be conducted by collecting sufficient samples and reflecting deviation of follow-up period.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권6호
• /
• pp.2857-2860
• /
• 2012

Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.

• Journal of Preventive Medicine and Public Health
• /
• 제52권6호
• /
• pp.377-383
• /
• 2019

Objectives: Self-reported disease history is often used in epidemiological studies. In this study, we acquired the hospital records of subjects who self-reported stroke or myocardial infarction (MI) and evaluated the validity of the participants' self-reported disease history. We also determined the level of agreement between specialists and non-specialists. Methods: Among the participants in the Health Examinees study, 1488 subjects self-reported stroke or MI during 2012-2017, and medical records were acquired for the 429 subjects (28.8%) who agreed to share their medical information. Each record was independently assigned to 2 medical doctors for review. The records were classified as 'definite,' 'possible,' or 'not' stroke or MI. If the doctors did not agree, a third doctor made the final decision. The positive predictive value (PPV) of self-reporting was calculated with the doctors' review as the gold standard. Kappa statistics were used to compare the results between general doctors and neurologists or cardiologists. Results: Medical records from 208 patients with self-reported stroke and 221 patients with self-reported MI were reviewed. The PPV of self-reported disease history was 51.4% for stroke and 32.6% for MI. If cases classified as 'possible' were counted as positive diagnoses, the PPV was 59.1% for stroke and 33.5% for MI. Kappa statistics showed moderate levels of agreement between specialists and nonspecialists for both stroke and MI. Conclusions: The validity of self-reported disease was lower than expected, especially in those who reported having been diagnosed with MI. Proper consideration is needed when using these self-reported data in further studies.

• 의료법학
• /
• 제20권1호
• /
• pp.243-279
• /
• 2019

2018년 주요 판결 중에는 법리적으로 새로운 판결을 발견하기 어려운데, 이는 어느 정도 법리가 확립되었고, 손해배상이라는 틀 안에서 주로 사실관계에 대한 다툼에 집중하기 때문인 것으로 이해된다. 과실판단이 심급끼리 상반된 사례들은 그 사유와 법리를 이해하는데 도움이 되었으며 갈수록 의료소송에서 다툼이 치열해짐을 확인할 수 있었다. 책임제한을 하지 않은 판결들과 의무기록기재 관련 판결 등도 눈에 띄었는데, 특히 의무기록 기재 관련 판결들이 상당히 증가한 것으로 보인다. 이는 당사자들이 의무기록 관련 의문을 제기하는 사건들이 늘어나는 현상의 일환으로 생각되고 이번 기회에 몇 개판례를 분류하여 소개하였다. 장기입원환자의 퇴거 및 진료비 청구 사례는 의료과실로 인한 후유증 치료에 소요된 진료비는 환자에게 청구할 수 없다는 취지의 대법원의 판결 이후 퇴원 거부와 장기입원을 하는 환자들이 늘어가는 현실에서 법리적으로 관심이 가는 판결이어서 소개하였다.