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'퇴원설명문'에 의한 72시간내 부적절한 응급센터 재방문의 감소
박하영,심민섭,송형곤,송근정 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.1
Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.
( Hyoung Seob Park ),( Hyung Seop Kim ),( Ji Hyun Sohn ),( Hong Won Shin ),( Yun Kyeong Cho ),( Hyuck Jun Yoon ),( Chang Wook Nam ),( Seung Ho Hur ),( Yoon Nyun Kim ),( Kwon Bae Kim ),( Hee Joon Park 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.3
Background/Aims: In patients with heart failure (HF), N-terminal prohormone brain natriuretic peptide (NT-ProBNP) is a standard prognostic indicator. In addition, uric acid (UA) was recently established as a prognostic marker for poor outcome in chronic HF. The aim of this study was to determine the combined role of UA and NT-ProBNP as prognostic markers for short-term outcomes of acute heart failure (AHF). Methods: The levels of UA and NT-ProBNP were determined in 193 patients (age, 69±13 years; 76 males) admitted with AHF. Patients were followed for 3 months and evaluated for cardiovascular events, defined as cardiac death and/or readmission for HF. Results: Of the 193 patients, 23 (11.9%) died and 20 (10.4%) were readmitted for HF during the 3-month followup period. Based on univariate analysis, possible predictors of short-term cardiovascular events were high levels of UA and NT-ProBNP, low creatinine clearance, no angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and old age. Multivariate Cox hazard analysis showed that UA levels were independently associated with increased incidence of cardiovascular events (hazard ratio, 1.115; 95% confidence interval, 1.006 to 1.235; p=0.037). Kaplan-Meier survival analysis revealed that patients with UA levels >8.0 mg/dL and NT-ProBNP levels >4,210 pg/mL were at highest risk for cardiac events (p=0.01). Conclusions: The combination of UA and NT-ProBNP levels appears to be more useful than either marker alone as an independent predictor for short-term outcomes in patients with AHF. (Korean J Intern Med 2010; 25:253-259)
Genetic Analysis of SCN5A in Korean Patients Associated with Atrioventricular Conduction Block
Park, Hyoung-Seob,Kim, Yoon-Nyun,Lee, Young-Soo,Jung, Byung-Chun,Lee, Sang-Hee,Shin, Dong-Gu,Cho, Yong-Keun,Bae, Myung-Hwan,Han, Sang-Mi,Lee, Myung-Hoon Korea Genome Organization 2012 Genomics & informatics Vol.10 No.2
Recent several studies have shown that the genetic variation of SCN5A is related with atrioventricular conduction block (AVB); no study has yet been published in Koreans. Therefore, to determine the AVB-associated genetic variation in Korean patients, we investigated the genetic variation of SCN5A in Korean patients with AVB and compared with normal control subjects. We enrolled 113 patients with AVB and 80 normal controls with no cardiac symptoms. DNA was isolated from the peripheral blood, and all exons (exon 2-exon 28) except the untranslated region and exon-intron boundaries of the SCN5A gene were amplified by multiplex PCR and directly sequenced using an ABI PRISM 3100 Genetic Analyzer. When a variation was discovered in genomic DNA from AVB patients, we confirmed whether the same variation existed in the control genomic DNA. In the present study, a total of 7 genetic variations were detected in 113 AVB patients. Of the 7 variations, 5 (G87A-A29A, intervening sequence 9-3C>A, A1673G-H558R, G3578A-R1193Q, and T5457C-D1819D) have been reported in previous studies, and 2 (C48G-F16L and G3048A-T1016T) were novel variations that have not been reported. The 2 newly discovered variations were not found in the 80 normal controls. In addition, G298S, G514C, P1008S, G1406R, and D1595N, identified in other ethnic populations, were not detected in this study. We found 2 novel genetic variations in the SCN5A gene in Korean patients with AVB. However, further functional study might be needed.
빈맥질환의 최신 지견 ; 삽입형 제세동기 및 심장재동기화 치료
박형섭 ( Hyoung-seob Park ) 대한내과학회 2016 대한내과학회지 Vol.90 No.3
The use of an implantable cardioverter-defibrillator (ICD) is an effective treatment strategy for patients with aborted sudden cardiac death (SCD) and ventricular tachyarrhythmias. Primary prevention of SCD is a strategy involving the use of ICDs in patients who are at high risk for but who have not had any previous events of ventricular arrhythmias or cardiac arrest. Cardiac resynchronization therapy (CRT) improves symptoms of heart failure and left ventricular systolic function when used in patients with severe heart failure symptoms, reduced left ventricular ejection, and a wide QRS complex. CRT has also been proven to reduce the rate of hospitalization due to heart failure as well as the rate of death from any cause. In this review, we discuss the clinical trials and current clinical indications for the ICD and CRT. (Korean J Med 2016;90:210-216)
종설 : 돌연사의 일차적 예방을 위한 삽입형 제세동기 치료
박형섭 ( Hyoung Seob Park ),한성욱 ( Seongwook Han ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
Implantable cardioverter-defibrillators (ICDs) are an effective treatment strategy for patients with aborted sudden cardiac death (SCD) and ventricular tachyarrhythmias. rimary prevention of SCD is a strategy involving the use of ICDs in patients who are at high risk for, but have not had, any previous events of ventricular arrhythmias or cardiac arrest. Several randomized clinical trials have demonstrated the efficacy of ICDs in the primary prevention of SCD. Therefore, ICD implantation is recommended as a standard of care by the guidelines in patients who have ischemic or nonischemic cardiomyopathy and a low left ventricular ejection fraction. However, the rates of ICD implantation as a primary prevention in Korea is quite low compared to western countries. In this review, we will summarize the results and efficacy of ICDs in the clinical trials about primary prevention of SCD, the current treatment guidelines, and the reimbursement policy of Korean health insurance. We hope that this review will help broaden the recognition of importance of ICD implantation for the primary prevention of SCD. (Korean J Med 2016;90:115-120)
비식량자원 기반 혼합 바이오액(impurity sugar)이 함침된 하이브리드석탄의 제조 및 그 연료 특성에 관한 연구
박주형(Ju-Hyoung Park),송규섭(Gyu-Seob Song),이영주(Young-Joo Lee),박세준(Se-Joon Park),남궁훤(Hueon Namkung),이동욱(Dong-Wook Lee),최종원(Jong Won Choi),김정근(Joeng-Geun Kim),송광호(Kwang Ho Song),최영찬(Young-Chan Choi) 대한설비공학회 2017 대한설비공학회 학술발표대회논문집 Vol.2017 No.11