• Title/Summary/Keyword: Obstetrical and gynecological

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Korean and United States: Comparison of Costs of Nursing Interventions (NIC과 연계된 산부인과 환자 간호중재에 대한 한국 건강보험 수가체계와 미국 ABC 코드체계와의 수가 비교 분석)

  • Hong, Sung-Jung;Lee, Eun-Joo
    • Korean Journal of Adult Nursing
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    • v.24 no.4
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    • pp.358-369
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    • 2012
  • Purpose: This study was performed to compare the costs of nursing interventions implemented for the obstetrical and gynecological patients using Korean Reimbursement System and ABC codes system developed in the US for costing out interventions performed by health care professional. Methods: First, the narrative data on nursing interventions were extracted from electronic medical record system of a tertiary university and mapped with Nursing Intervention Classification (NIC) by two researchers until 100% consent was reached. Narrative nursing interventions mapped with NIC were then remapped with ABC codes system using the electronic program developed in the research. The mapping data were analyzed with real numbers, frequency, percentage, mean, and standard deviation. Results: More nursing interventions were mapped with ABC codes than Korean reimbursement system. Total of 97 different types of narrative interventions could be mapped with NIC, 43 NIC interventions could be reimbursed by ABC code but only 16 NIC interventions were reimbursed by Korea Reimbursement System. Conclusion: Korean medical insurance fee system needs amendment to include more comprehensively interventions performed by nurses which are very important to patient outcomes. Further study is needed to develop strategies to costing out nursing interventions.

An Analysis of Clinical Application of Guibi-tang for Obstetrics and Gynecological Disease (동국대학교 일산한방병원 여성의학과에서의 귀비탕(歸脾湯) 임상 적용 사례 분석 연구)

  • Park, Jang-Kyung;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.2
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    • pp.79-96
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    • 2011
  • Objectives: This study was to investigate clinical usage of Guibi-tang based on actual application in obstetrics and gynecology. Methods: This study investigated the number of patients who were prescribed Guibi-tang-gami-bang and what herbal medicines were adjusted according to their chief complaint from January 1st, 2007 to August 31th, 2008. Results: The number of patients who were prescribed Guibi-tang for obstetrics and gynecological diseases at the Department of Obstetrics and Gynecology was 721. Guibi-tang has been used to treat menstrual irregularity, postpartum general weakness, postpartum pantalgia, perimenopausal symptoms and postmenopausal syndrome most frequently. And Guibi-tang has been widely used in obstetric and gynecologic diseases such as general weakness after abortion or gynecological surgery, pelvic pain, dysmenorrhea, uterine myoma, endometriosis, infertility, premenstrual syndrome, urinary incontinence and breast disease. Conclusions: Guibi-tang can be used in obstetric and gynecologic diseases as described in classical oriental medicine literatures, and it is necessary to research clinical usage of Guibi-tang through randomized controlled trial.

Obstetrical & Gynecological Health Status and Body Composition of Married Immigrant Women in Busan (결혼이주여성의 생식건강상태와 체성분 조성)

  • Kim, Dong-Hee;Park, Hyoung-Sook;Bae, Kyung-Eui
    • Journal of Life Science
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    • v.20 no.6
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    • pp.894-901
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    • 2010
  • The purpose of this study was to examine obstetrical & gynecological health status and body composition for married female immigrants. The participants were 154 immigrant women living in Busan. Data were collected from July 2008 to July 2009 using a questionnaire and a bioelectrical impedance analysis tool (Inbody 720) for analysis of body composition. Most subjects were in the normal range for body composition, but some of those who answered the questionnaire had experienced some gynecological problems such as dysmenorrhea, or irregular menstruation. There was a significant difference in experiences with in vitro fertilization, pregnancy and abortion according to age and in premensturaion syndrome, as well as differences in regulation of menstruation during the past year, leukorrhea odor, experiences in in vitro fertilization, and delivery and breastfeeding according to nationality. There were significant differences in body mass index and waist-hip ratio according to age, as well as differences in percent body fat, body mass index and waist-hip ratio according to nationality. There were also significant differences in body mass index and waist-hip ratio according to period of stay in Korea. Procreative care protocols concerning married female immigrants' characteristics should be developed.

The Research of Oriental Obstetrical & Gynecological Point of View on Woman's Breast Disease (유방질환에 관한 한방부인과적 연구)

  • Kim, Yoon-Sang;Lim, Eun-Mee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.3
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    • pp.103-116
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    • 2012
  • Objectives: The aim of this study is to differentiate women from men on breast diseases. Methods: We have searched antique books, texts and references of oriental obstetric & gynecology and checked into present conditions of oriental medicine hospitals in republic of Korea. Results: In physiological, pathological and epidemiological viewpoint of both oriental and western medicine, it was accepted that women were different with men on breast disease. Among references published in the Journal of Oriental Obstetrics and Gynecology from 1987, the number of references concerned breast disease was fifty divided into 29 original articles(58%) in types and 26 breast cancer(52%), 13 postpartum lactation(26%) in categorizations. and woman's breast disease and cancer taken charge on oriental obstetrics and gynecology in oriental medicine hospitals were 25(86%) and 19(66%) respectively. Conclusions: We could not realize that woman's breast disease already were accepted woman's particularity in various aspects until conducting our study. Accordingly, it is suggested that more researches would be conducted on the needs of female patients with breast disease through questionnaire or research and on the association reproductive factor and breast disease of women.

The role of autophagy in the placenta as a regulator of cell death

  • Gong, Jin-Sung;Kim, Gi Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.3
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    • pp.97-107
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    • 2014
  • The placenta is a temporary fetomaternal organ capable of supporting fetal growth and development during pregnancy. In particular, abnormal development and dysfunction of the placenta due to cha nges in the proliferation, differentiation, cell death, and invasion of trophoblasts induce several gynecological diseases as well as abnormal fetal development. Autophagy is a catalytic process that maintains cellular structures by recycling building blocks derived from damaged microorganelles or proteins resulting from digestion in lysosomes. Additionally, autophagy is necessary to maintain homeostasis during cellular growth, development, and differentiation, and to protect cells from nutritional deficiencies or factors related to metabolism inhibition. Induced autophagy by various environmental factors has a dual role: it facilitates cellular survival in normal conditions, but the cascade of cellular death is accelerated by over-activated autophagy. Therefore, cellular death by autophagy has been known as programmed cell death type II. Autophagy causes or inhibits cellular death via the other mechanism, apoptosis, which is programmed cell death type I. Recently, it has been reported that autophagy increases in placenta-related obstetrical diseases such as preeclampsia and intrauterine growth retardation, although the mechanisms are still unclear. In particular, abnormal autophagic mechanisms prevent trophoblast invasion and inhibit trophoblast functions. Therefore, the objectives of this review are to examine the characteristics and functions of autophagy and to investigate the role of autophagy in the placenta and the trophoblast as a regulator of cell death.

Role of Trophobolast in Implantation and Placenta Development (착상 및 태반 발달과정에 따른 영양막세포의 역할)

  • Kim, Gi-Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.181-189
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    • 2010
  • The placenta, which is a temporary organ derived from the fetus during pregnancy, is critical to support fetus development via optimal regulation between mother and fetus. Trophoblast as a major cell population of the placenta is one of the earliest to differentiate and shows an extensive proliferation or/and differentiation up to the formation of the placenta. The role of the trophoblast show dynamic changes from early embryo implantation to placentation during pregnancy. Implantation of the blastocyst into the endometrium of the maternal uterus is mediated by invasion of the differentiated trophoblast (e.g. syncytiotrophoblast) from the trophectoderm. During pregnancy, the unique role of the trophoblast is to invasion, eroding, and metastasizing in the placenta as well as to ensure appropriate bidirectional nutrient or waste flow required for growth and maturation of the embryo. The dysfunction of the trophoblast during pregnancy can result in several gynecological diseases including preeclampsia and congenital malformation in neonatal medicine. Therefore, trophoblasts act as a conclusive factor in placental and fetal development. This brief review outlines the classification of trophoblast and its function in the placenta during pregnancy. Also, we introduce the latest research in trophoblast for implantation and the placenta development, and the application potential of trophoblast for infertility and obstetrical diseases.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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