• The Journal of Korean Society for Radiation Therapy
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• v.7 no.1
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• pp.156-166
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• 1995

Total body irradiation (TBI) requires large radiation field and extended source to axis distance (SAD), therefore in needs large size treatment room and it needs compensators which components. Appropriate thickness beam spoiler should be used to raise skin dose. Treatment machine, photon energy, total dose, dose rate, dose fractionation, patient position, shield of normal tissues and organs were known to important parameters for TBI. TBI disturbes regular daily treatment schedule and significantly overloads Radiation on oncology departments and during the treatment session it requires accurate reproduction of radiation field and patient position. We were enable to TBI in small size treatment room and short SAD with parallel opposing lateral fields technique and achieved homogenious whole body dose distribution using pb compensators and controled lung dose by lung shield blocks. Drawing a patient shadow on the wall, we could shortened set up time and possible to accurate reproduction of radiation field and patient position.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.237-246
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• 2016

This study is therefore aimed at measuring the surface dose rate and the spatial dose rate in and outside the radionuclide facility in order to ensure safety of the patients, radiation workers and family care-givers in their use of such equipment and to provide a basic framework for further research on radiation protection. The study was conducted at 4 restrooms in and outside the radionuclide facility of a general hospital in Incheon between May 1 and July 31, 2014. During the study period, the spatial contamination dose rate and the surface contamination dose rate before and after radiation use were measured at the 4 places-thyroid therapy room, PET center, gamma camera room, and outpatient department. According to the restroom use survey by hospitals, restrooms in the radionuclide facility were used not only by patients but also by family care-givers and some of radiation workers. The highest cumulative spatial radiation dose rate was 8.86 mSv/hr at camera room restroom, followed by 7.31 mSv/hr at radioactive iodine therapy room restroom, 2.29 mSv/hr at PET center restroom, and 0.26 mSv/hr at outpatient department restroom, respectively. The surface radiation dose rate measured before and after radiation use was the highest at toilets, which are in direct contact with patient's excretion, followed by the center and the entrance of restrooms. Unsealed radioactive sources used in nuclear medicine are relatively safe due to short half lives and low energy. A patient who received those radioactive sources, however, may become a mobile radioactive source and contaminate areas the patient contacts-camera room, sedation room, and restroom-through secretion and excretion. Therefore, patients administered radionuclides should be advised to drink sufficient amounts of water to efficiently minimize radiation exposure to others by reducing the biological half-life, and members of the public-family care-givers, pregnant women, and children-be as far away from the patients until the dose remains below the permitted dose limit.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.46-54
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• 1996

Background : The medical record is a compilation of pertinent facts of a patient's life and health history, including past and present illness and treatment. It is written by the health professionals contributing to that patient's care. And the medical record is the permanent, legal document which must contain sufficient information to identify the patient, justify the diagnosis and treatment, and record the results. As such, it must be accurate and complete. So we try to analyze the medical record especially a kind of incomplete record, loose laboratory reports. Methods: During the one-year period(from January to December 1988), a medical record practitioner examine and analyze the record of laboratory reports at K Hospital in Seoul. A total of 320 loose laboratory reports for 3,818 admitted laboratory reports. And a medical record practitioner and a physician review and analyze the influencing factors for the various reasons of clinical and laboratory aspects. Result: The loose percentage by department is the highest in obstetrics(40.4%) but the highest loose rate is in pediatrics(25.0%). The most of omission is occurred in operation room(80.3%) than OPD(19.7%). The change of diagnosis is according to duration of laboratory and more changable in cancer patient. Conclusion : Regular analysis of the documentation in the medical record so it fulfills its purposes of communicating patient care information. So it serves as evidence of the patient's course of illness and treatment for various legal, reimbursement, and peer evaluation review. And it is very important aspect of quality assurance in medical activities.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.131-145
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• 2009

Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.309-314
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• 2011

Purpose: Necrotizing fasciitis is a life-threatening, destructive soft tissue infection with a very high rate of mortality that needs early diagnosis and aggressive treatment. Systemic Lupus Erythematosus (SLE) is a systemic, autoimmune disease and it's major cause of mortality is an infection. But necrotizing fasciitis in SLE is very rare and there have been only 22 cases reported in the literatures. We reported a patient of necrotizing fasciitis with SLE and reviewed 22 others from literature research. Methods: A 40-year-old female patient with a history of SLE for 6 years came to the emergency room. The patient complained of severe pain and swelling on her right leg. She was diagnosed as necrotizing fasciitis and underwent emergency fasciotomy. As wound cultures showed variable organisms, she was treated with broad-spectrum antibiotics and underwent several surgical debridements. Then, the wound was treated with the V.A.C (Vacuum Assisted Closure) device and split thickness skin grafting was performed two times. Results: Skin graft was well taken within 2 weeks after operations and the patient was discharged to outpatient follow up. There was no complication related with surgery and she could walk without cane after 3 months. Conclusion: We treated a necrotizing fasciitis in a patient with SLE and reviewed 22 others from literature research. The case presented here suggests that necrotizing fasciitis is a rare disease in SLE patients, but should be considered in the differential diagnosis of soft tissue infection in SLE patients. A high index of suspicion is needed for early diagnosis and proper management in these patients.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.666-677
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• 2000

The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.304-307
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• 2013

Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2009.05a
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• pp.899-902
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• 2009

As computer network and wireless technology continue to grow rapidly, a wide range of remote application has been applied to medical field such as remote medical consulting and remote patient monitoring. This research aims to design RF telecommunication-based healthcare application to collect and manage patient's physiological data, and describe the overall procedure of experiment. MySQL database is designed to record patient's physiological data including temperature, blood pressure and heart rate and save information about medical behaviors such as doctor's prescription for patients. Therefore, users approved by healthcare application can query patient's data and collected data can be used to reorganize data for clinical test. As a result, temperature and humidity of patient's room which must be checked frequently can be processed automatically through ubiquitous sensor network. The information entered from mobile phones or web is saved in database, ensuring systematical management through computer. Moreover, patient's family members can easily access hospital data, improving their experience with medical service.

• Journal of Advanced Navigation Technology
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• v.27 no.1
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• pp.139-145
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• 2023

When a doctor examines a patient in a hospital, the doctor directly checks the patient's condition and conducts a face-to-face diagnosis through dialogue with the patient. However, it is often difficult for doctors to directly treat patients. Recently, several types of telemedicine systems have been developed. However, the systems have lack of capabilities to observe heart disease, neck condition, skin condition, inside ear condition, etc. To solve this problem, in this paper, an interactive telemedicine robot system with autonomous driving in a room capable of visual examination and auscultation of patients is developed. The developed robot can be controlled remotely through the WebRTC platform to move toward the patient and check a patient's condition under the doctor's observation using the multi-joint robot arm. The video information, audio information, patient's heart sound, and other data obtained remotely from patients can be transmitted to a doctor through the web RTC platform. The developed system can be applied to the various places where doctors are not possible to attend.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.72-78
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• 1994

A naso-orbito-ethmoid(NOE) fracture is very complex diagnostically and therapeutically. The diagnosis of this fractures is usually made by physical findings aided by a CT scan. The primary treatment of NOE fracture must be directed toward the reconstruction of medial canthal ligament and bony skeleton. We prefer to correct lacrimal system abnormalities secondarily A 32-year old male patient visited emergency room of our hospital with NOE fracture. After emergency treatment and consultation with neurosurgery and ophthalmology, we treated this patient by performing reconstruction of medial canthal ligament, bone graft of media orbital rim blowout fracture, and dorsal nasal cantilever bone graft with calvarial bone. The authors present a case report with literature review.