• 제목/요약/키워드: Referral

검색결과 627건 처리시간 0.022초

근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성 (Characteristics of teeth referred to a dental university hospital for endodontic reason)

  • 전수진;황수정;서민석
    • 구강회복응용과학지
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    • 제35권3호
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    • pp.143-152
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    • 2019
  • 목적: 이번 연구의 목적은 치과대학병원 보존과로 근관치료적으로 의뢰된 환자들과 치아들의 특성을 진료기록을 통해 살펴보고 영향을 미치는 요인을 분석하는 것이다. 연구 재료 및 방법: 2017년 1월부터 2018년 12월까지 한 치과대학병원 보존과에 내원한 환자들을 대상으로 환자의 진료기록을 통해 근관치료적으로 의뢰되었던 환자를 취합하였다. 총 1171명의 환자 기록을 분석하였다. 의뢰된 치아의 상태가 근관치료 전인지 근관치료 중인지 또는 근관 충전된 이후인지를 초진 당시의 방사선 사진과 진료기록 내용을 토대로 구분하여 3가지 군으로 정리해서 분석하였다. 결과: 의뢰된 치아들의 69.9%가 상, 하악 제1, 2대구치였다. 이전 기관에서 의뢰된 후 치과대학병원에 내원할 때까지 소요된 일수는 평균 9.03일이었고 의뢰서가 있는 경우가 65.6%였다. 주된 의뢰 이유로는 지속되는 임상 증상(통증, 종창, 누공)이 37.9%로 가장 많았으며 진단의 어려움 16.7%, 근관막힘 13.8%, 높은 해부학적 난이도 11.4% 순이었다. 세부적으로 근관치료 전에 의뢰된 경우에는 진단의 어려움이 많았고 근관치료 중에 의뢰된 경우에는 지속적인 임상 증상과 근관 막힘이 많았다. 근관 충전 후에 의뢰된 경우는 지속되는 임상 증상이 대부분이었다. 결론: 대구치인 경우 지속적인 임상 증상과 근관 막힘이 주된 이유인 비율이 높았고 전치의 경우 치근단 수술과 외상 치료의 비율이 높았다.

시계열 개입 분석을 이용한 환자의뢰제도의 개입효과 평가 (An Evaluation of a Patient Referral System using Intervention Analysis)

  • 조우현;이해종;손명세;남정모;유승흠
    • Journal of Preventive Medicine and Public Health
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    • 제22권2호
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    • pp.236-241
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    • 1989
  • The purpose of this study was to introduce the methodology of intervention analysis with time series data and to investigate the influence of the patient referral system on medical care utilization in Kangwha county. The data were obtained at the Kangwha Medical Inurance Society and we analysed the material based on the outpatient care fee. The results were as fellows: 1. The average outpatient care utilization in the hospital decreased by 41.7% due to the patient referral system. 2. The utilization of the health instituation increased by 278.8 persons per month due to the patient referral system. 3. The patient referral system did not influence the total outpatient are utilization. The methodology of intervention analysis, which detected the effect of intervention, will be helpful to the study of public health area.

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개에서 골화생을 동반한 전립선 주위종의 영상의학 증례 (Diagnostic Imaging of Paraprostatic Cyst with Osseous Metaplasia in a Dog)

  • 최지혜;계서연;김성수;최희연;김현욱;윤정희
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.468-473
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    • 2010
  • A 6-year-old intact male Doberman pinscher presented with a thin soft stool and urinary signs. On radiography, three masses were observed in the caudal abdomen. One mass was described as a large, round, mineralized mass, with an "eggshell" appearance. The second mass was located caudal to the mineralized mass, and the third mass was located between the two masses. The second and the third masses had a soft tissue density. Ultrasonography was performed to identify the features and the origins of the masses. The first mass contained a large amount of anechoic fluid and had a thin wall; it was determined to be a cyst. Strong acoustic shadowing artifact was created by the mineralized cystic wall. Caudal to the cyst, the second mass was shown to be the prostate. A hypoechoic stalk connected the prostate and the cyst, which represented the cyst as a paraprostatic cyst with mineralization. The third mass was the normal urinary bladder. The cyst was removed surgically and confirmed by histopathologic examination. This report described typical clinical findings, diagnostic imaging, and treatment of a paraprostatic cyst.

개의 종괴형 간세포암종에 대한 진단 영상 소견에 대한 고찰 (Diagnostic Imaging of Massive Hepatocellular Carcinoma in 5 Dogs)

  • 최지혜;김아림;계서연;최희연;장재영;윤정희
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.474-482
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    • 2010
  • Hepatocellular carcinoma (HCC) is a primary hepatic neoplasms in dogs. Three types of HCC such as massive, nodular and diffuse form were reported. Massive HCC is most common and has relatively better prognosis than other forms because this type of HCC can be removed surgically and has low frequency of relapse or metastasis. Diagnostic image can provide useful information for shape and internal structure of the hepatic mass as well as the location and adhesion or invasiveness of the mass to establish surgical plan to remove the mass safely. In this study, we investigated diagnostic features of massive HCC in 5 dogs. Radiography showed soft tissue mass in cranial abdomen in 3 dogs. On ultrasonography, all dogs had a solitary hepatic mass with mixed echo pattern with anechoic cysts, which represented necrosis and hemorrhage. The radiographic and ultrasonographic findings of affected hepatic lobe were compared with the macroscopic findings through laparotomy. Computed tomography was performed to check metastasis and figure out the origin of the mass in two dogs. Ultrasonography is useful and relatively sensitive examination for diagnosis and planning for surgery in canine massive HCC.

간호사의 전원상담 효과 예측을 위한 시스템다이내믹스 모델 개발 및 분석 (Development and Analysis of System Dynamics Model for Predicting on the Effect of Patient Transfer Counseling with Nurses)

  • 변혜민;윤은경
    • 대한간호학회지
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    • 제48권5호
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    • pp.554-564
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    • 2018
  • Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

Renal Rupture by Cystadenocarcinoma in a Yorkshire Terrier

  • Choi, Ji-Hye;Kim, Jin-Kyung;Jang, Jae-Young;Kim, Hyun-Wook;Kim, Jun-Young;Yoon, Jung-Hee
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.224-226
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    • 2008
  • A 13-year-old, spayed female, Yorkshire terrier was presented with a history of vomiting and diarrhea. Radiographic and ultrasonographic studies suggested rupture of right renal cyst. Left kidney had increased cortical echogenecity with indistinct corticomedullary junction on sonogram. Unilateral nephroureterectomy of right kidney was performed. Histopathologic examination of the resected renal mass confirmed a renal cystadenocarcinoma. To the best of our knowledge, it is the first case report of renal cystadenocarcinoma in a small breed dog in Korea.

개 췌장 위낭종에서 초음파 유도 흡인 생검을 통한 진단 및 치료 2례 (Diagnosis and resolution of pancreatic pseudocysts with percutaneous ultrasound-guided aspiration in two dogs)

  • 최지혜;김현욱;서지민;이민정;김준영;윤정희
    • 대한수의학회지
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    • 제47권3호
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    • pp.341-347
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    • 2007
  • Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.

공공도서관의 정보 및 안내봉사 도입을 위한 연구 (Information and referral service in public libraries)

  • 조명희;박준식
    • 한국도서관정보학회지
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    • 제23권
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    • pp.183-209
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    • 1995
  • The purpose of this study was to obtain the various basic data for introduction of information and referral service in the Korean public libraries. For the purpose, this study was conducted by carrying out theoretical research on the concept and definition of information and referral service, the type and level of the service and the needs for introduction of the service in public libraries and using questionnaires with 242 public libraries(reference librarians) all over the country, so as to examine the librarians' views on the whole service. The questionnaire mainly included questions about actual status, present level and understanding level of the service, reference librarians' response to needs for introduction of the service, and type and level of the service available when the service has been introduced. In conclusion, this study will help to establish basic foundation, so that the Korean public libraries can realize equalization of the service and promote the information and referral service.

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Surgical Repair of Diaphragmatic Hernia-Related Small Intestinal Strangulation in a Neonatal Foal

  • Jungho Yoon;Jeechan Choi;Soomin Ko;Ahram Kim
    • 한국임상수의학회지
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    • 제40권5호
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    • pp.354-359
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    • 2023
  • This case report describes the clinical presentation and successful surgical repair of a diaphragmatic hernia-related small intestinal strangulation in a neonatal foal. A nine-day-old foal presented with colic signs and respiratory distress. History taking showed that the dam of the foal experienced difficulty during delivery, and the owner assisted in delivery by pulling on the foal. Radiography and ultrasonography confirmed the diaphragmatic rent and the presence of a small intestine within the thoracic cavity. Surgical intervention was required to repair the diaphragmatic defect and address the intestinal strangulation. The diaphragm was reconstructed, and the nonviable incarcerated portion of the small intestine was resected and anastomosed using an end-to-end technique. This unusual case report provides insights into the surgical repair and outcomes of an acquired diaphragmatic hernia in a neonatal foal.