• 정신신체의학
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• 제6권1호
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• pp.46-58
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• 1998

Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.

• 대한수의학회지
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• 제52권3호
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• pp.205-208
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• 2012

Endocrine test data from a 13-year old intact female Maltese was indicative of the presence of an insulinoma, however ultrasonography identified a pancreatic mass only after 10 months after the first admission. Following identification of both pancreatic tumor and hepatic metastasis on computed tomography (CT), surgical excision of the mass was attempted. However, total excision failed because of tumor adhesion to adjacent large vessels. The pancreatic mass was monitored over the next 25 months via ultrasonography, CT, and positron emission tomography-computed tomography (PET-CT). Histopathological and immunohistochemical data confirmed the diagnosis of insulinoma with hepatic metastasis.

• Healthcare Informatics Research
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• 제24권4호
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• pp.317-326
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• 2018

Objectives: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. Methods: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. Results: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. Conclusions: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.259-259
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• 2009

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.232-232
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• 2009

• 한국임상수의학회지
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• 제25권6호
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• pp.523-525
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• 2008

11 year old male Yorkshire terrier was referred to Haemaru Referral Animal Hospital with signs of hematuria, petechia, and gynecomastia. Blood works revealed severe leukopenia, moderate anemia and severe thrombocytopenia. On ultrasonography and radiography, mixed echo texture mass was found in abdomen. The abdominal mass was surgically removed, and submitted for histopathology. Histopathologic features of the tissues were consistent with malignant Sertoli cell tumor. Bone marrow aspirates were hypocellular. Serum estrogen concentration was 72.80 pg/ml (normal range for females <15 pg/ml) after surgery. Clinical signs of feminization and hemorrhagic diathesis were attributed to hyperestrinism caused by the tumor. The dog was put on fluid therapy, antibiotics and palliative drugs and survived 2 more weeks after surgery without clinical improvement.

• 한국학교보건학회지
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• 제34권1호
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• pp.33-41
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• 2021

Purpose: Exploring the variables that predict teachers' intent when referring students to mental health professionals is important. The Theory of Planned Behavio (TPB) is a theory of predicting people's intentions of performing a particular behavior; the intent to perform a certain behavior is determined by three factors. (1) attitudes toward the behavior, (2) subjective norms, and (3) perceived control. This study aimed to develop a TPB measurement to investigate what variables predict the intentions of teacher's referral behaviors. Methods: A qualitative study following standardized manuals and guidelines for developing a TPB measurement was used. As a qualitative research method, the Consensual Qualitative Research-Modified (CQR-M) was used. According to the findings from the qualitative study, the quantitative measurement to assess teachers' referral intention, attitude, subjective norm, and behavioral control was developed. Results: The reliability and validity of the newly developed measurement were tested and verified. Conclusion: The newly developed measurement would contribute to a future empirical study that will examine predictors of teachers' referral intention.

• Journal of Microbiology and Biotechnology
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• 제25권11호
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• pp.1966-1969
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• 2015

Canine atopic dermatitis (CAD) is a ubiquitous, chronic inflammatory skin disorder prevalent in dogs, which results in production of abnormal levels of IgE antibodies in reciprocation to an allergen challenge. In this study, administration of the probiotic strain Lactobacillus sakei probio-65 for 2 months significantly reduced the disease severity index in experimental dogs diagnosed with CAD. In addition, one month pre-medication of L. sakei probio-65 revealed significant difference in the PVAS score in experimental dogs for both probio-65 and placebo groups. However, post 2 months treatment resulted in a significant decrease in the CASESI score values in the probio-65-treated group (p < .0.06).

• 한국임상수의학회지
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• 제26권1호
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• pp.76-80
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• 2009

A Maltese was presented with a subcutaneous mass at right flank, depression and hyperthermia. Ultrasonography revealed a hypoechoic mass with hyperechoic foci, a defect of abdominal wall and peritonitis. In cytology, fat necrosis was found. This dog was diagnosed as chronic suppurative steatitis secondary to pancreatitis and pancreatic herniation through surgery and histopathologic examination. Steatitis is recurrent inflammation and necrosis of adipose tissue. Also steatitis associated with pancreatic diseases such as pancreatitis and pancreatic tumor was reported and direct fat necrosis by pancreatic enzyme was supposed as the etiology. Steatitis secondary to pancreatitis was rarely reported in dogs and there was difficulty in diagnosis and treatment. This case has a limitation that pancreatitis was not diagnosed as underlying cause to steatitis before surgery. However, a defect of abdominal wall and peritonitis were observed on ultrasonography. Good prognosis could be achieved through prompt surgery and medical treatment.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.