• 한국임상약학회지
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• 제27권1호
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• pp.1-8
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• 2017

The prevalence of diabetes and its related morbidity and mortality are being increased. Despite the advancement of evidence-based pharmacotherapy in the management of diabetes, many patients in our country do not achieve satisfied therapeutic outcomes. Pharmaceutical care service can be defined as a patient-centered clinical service provided by pharmacists to improve therapeutic outcomes and quality of life of patients, by identifying, and preventing or resolving drug-related problems (DRPs). Pharmaceutical care service is interdisciplinary team-based practice, and is provided through collaborative practice agreement (CPA) between one or more physicians and pharmacists. This article describes a model of pharmaceutical care service which can be adopted in our country for patients with diabetes in the ambulatory care settings. With the successful implementation of this service, clinical, economic, and humanistic outcomes of patients will be improved. Therefore, by actively implementing pharmaceutical care service, pharmacist should contribute to the promotion of patients' health and to the advancement of health care delivery system.

• Journal of Chest Surgery
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• 제17권1호
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• pp.125-128
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• 1984

The management of the exposed cardiac pacemaker or its lead is a new challenge to the plastic surgeon. This complication is not rare. Coburn et al. [1972] reported less than 5 percent, but Sowton et al. [1974] showed that over a period of 19 years, in a series of 372 patients, the pacing system had to be removed because of local wound breakdown or infection in 10 percent of the cases. The methods used to treat exposure may vary from removal and re-introduction at anterior site to the rotation of local flaps to cover the exposed pacemaker. Recently we have experienced 6 times of migration and recurrent skin ulcerations without pyogenic infection overlying the pacemaker in one patient. We developed a new technique, anchoring the pacemaker to the clavicle by a wire through the hole of clavicle and by creating a pocket under the pectoralis major muscle. Then we would like to emphasize this operating method could be choice of treatment to prevent the migration of pacemaker and the ulceration of skin when complication of implantation of pacemaker is occurred.

• 정신신체의학
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• 제3권1호
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

• 대한한의학회지
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• 제26권2호
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• pp.105-125
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• 2005

Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.

• Journal of Chest Surgery
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• 제23권5호
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• pp.1021-1026
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• 1990

The patients with tracheal stenosis have become more increasing in recent due to the increased use of tracheostomy and assisted ventilation Anesthetic management during tracheal reconstruction is a concern to the anesthetist and the surgeon, who must share the airway as a operation field and at the same time provide good gas exchange. Multiple technique such as the tube ventilation system or C \ulcornerP bypass method have been recommended to achieve this goals. However, these methods have disadvantages of poor surgical exposure and hemorrhagic complication from using C \ulcornerP bypass The technique for HFJV was first described for bronchoscopy, and it involves positive-pressure breathing with high flow[40 \ulcorner60L/min] of oxygen This flow is directed to a semirigid catheter inserted in the endotracheal tube and the tracheal reconstruction can be done without interruption. From Dec. 1986 to July 1990 we have experienced 6 patients of tracheal stenosis necessitating circumferential resection and end to end anastomosis; 5 patients with tracheal stenosis following cuffed tracheostomy or intubation, a patient with tracheal stenosis due to invasive thyroid cancer. The specific advantages during tracheal reconstruction are unobstructed field during surgical reconstruction and good gas exchange through the procedure.

• 대한치과의사협회지
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• 제57권12호
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• pp.758-767
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• 2019

The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

• Journal of Trauma and Injury
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• 제29권2호
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• pp.51-55
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• 2016

Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.

• 가정∙방문간호학회지
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• 제2권
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• pp.77-88
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• 1995

The increase of the aged according to the prolongation of the average life and the phenomenon of the nuclear familization according to civilization or industrialization is being problem for not Japan but also our nation. Nevertheless, the authorities were not interesting to an old impidement man. But nowdays, our goverement intends to deal with demertia patient or old man such a problem by the foundation of rementia center over the country. Even though having many problem to have to check the problems, the preparation of legal and systematic equipment etc., for our goverment will have to prepare all measures for unmovable man to live leisurly in their home by analysing the management of social welfare system of the advanced country or Japan.

• 한국지능시스템학회논문지
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• 제18권6호
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• pp.849-855
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• 2008

The Diagnostic Unit of CLINAID can infer working diagnoses for general diseases from the information provided by a user. This user-provided information in the form of signs and symptoms, however, is usually not sufficient to make a final decision on a working diagnosis. In order for the Diagnostic Unit to reach a diagnostic conclusion, it needs to select suitable clinical investigations for the patients. Because different investigations can be selected for the same patient, we need a process that can optimize the selection procedure employed by the Diagnostic Unit. This process, called a selection algorithm, must work with the fuzzy relational method because CLINAID uses fuzzy relational structures extensively for its knowledge bases and inference mechanism. In this paper we present steps of the selection algorithm along with simulation results on this algorithm using fuzzy relational products, both harsh product and mean product. The computation results of applying several different fuzzy implication operators are compared and analyzed.

• 한국한의학연구원논문집
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• 제11권1호
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• pp.109-118
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• 2005

In a field of oriental medicine, it is necessary to collect systemically clinical data and integrate. Input data items was decided, then categorized by the modules through discussion of the institute and hospitals. Items are information of patient, history, aspects of occurrence, pattern identification, prescriptions of herbal medicine, the results of biochemical serum examination, blood cell count, urine analysis, CT, MRI, Chest PA, EKG etc. Factors in oriental medicine are Sasang constitution, Stroke-Pattern-Identification(china), differentiation of cold and heat syndrome. This tool was constructed by using Microsoft-Access 2000 and Microsoft Visual Basic 6.0. Furthermore this web-based system could be applied to multi-center clinical investigation.