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        방광종물에 대한 방광초음파검사의 진단적 유용성

        허정식,김성대,박경기,김영주,유현욱,Huh, Jung-Sik,Kim, Sung Dae,Park, Kyung Kgi,Kim, Young Joo,You, Hyun Wook 제주대학교 의과학연구소 2020 The Journal of Medicine and Life Science Vol.17 No.3

        Ultrasonography is used to examine gross or microscopic hematuria without side effects. It is one of the methods of diagnosing bladder lesions, but in some cases, the lesions are not found. We attempted to identify the problems during the ultrasonic examination by analyzing the symptoms, location of lesion, and medical history of urothelial cancer for cases of undetected bladder lesions. Thirty-three patients who underwent transurethral resection of a bladder tumor from January 1 to May 4, 2018 in one hospital were enrolled in this study. Patients who underwent preoperative ultrasonography and cystoscopy were treated. Ultrasonography did not detect bladder lesions in five patients. The size of the lesion was 0.5~2.5 cm in various locations, such as the side, front, and so on. Ultrasonic examination requires more attention if there is gross hematuria or a history of urothelial cancer, and it is necessary to detect recurrence by conducting cystoscopy at the same time, especially when there are lesions on the anterior wall of the bladder.

      • 연명의료결정법의 시행과 제도적 실현을 위한 방안

        허정식,김기영,Huh, Jung-Sik,Kim, Ki-Young 제주대학교 의과학연구소 2019 The Journal of Medicine and Life Science Vol.16 No.3

        First of all, this study shows the legal issues of hospice and palliative care, and the legal basis for lifelong medical practice is generally derived from medical, civil and criminal law regulations, and is applied to patients who are severely ill and dying in principle. In addition, those what is particularly meaningful about hospice and palliative care in terms of legal aspects are discussed the determination of the purpose of care and the provision of medical adaptability and adult guardianship, in particular the legal criteria for the work and status of patient representatives. As such, the purpose of care is to form part of the contract of care and to be agreed between the patient and the physician. In addition, the patient may not write to his/her agent in advance, and the patient may admit discretionary powers to his/her agent, but the patient's will is to be considered. In conclusion, the medical institutional ethics committee should play an active role, especially in the case of no-agents/family or no intention of the patient.

      • KCI등재
      • KCI등재후보

        제주지역에서의 호스피스.완화의료기관과 보건소의 재가암 관리 현황

        허정식,김현주,Huh, Jung-Sik,Kim, Hyeon-Ju 한국호스피스완화의료학회 2010 한국호스피스.완화의료학회지 Vol.13 No.2

        목적: 본 연구에서는 제주지역내의 보건소, 지역 암센터와 말기암환자 전문의료기관 등에서 실시하고 있는 재가암환자 관리 사업의 객관적 현황을 파악하여 각 기관별의 재가암 관리를 위한 역할을 정립하고자 한다. 방법: 제주지역에서 재가암환자 관리를 실시하고 있는 각 기관을 대상으로 재가암환자 관리 사업의 시작연도와 현재 실시하고 있는 사업과 부족한 부분 등을 알아보고, 각 기관과의 연관사업 등을 파악하였다. 결과: 제주지역내의 재가암환자 관리는 6개의 보건소와 1개의 지역 암센터, 1개의 말기암환자 전문의료기관이 활동 중에 있으며, 제공되는 서비스는 약간의 차이는 있으나, 신체적, 정서적, 영적, 교육 정보적 서비스를 실시하고 있으나 보건소의 경우, 통증완화를 위한 마약성 진통제의 사용이 부족한 실정이었다. 결론: 본 연구는 재가암환자 관리 사업에서 말기암환자 전문의료기관과 보건소에서 급성기의 경우와 재가암환자 관리를 위한 인력의 교육을 위한 교육은 지역 암센터와 연계하여 재가암환자에 대한 체계적인 관리와 역할 분담을 정립시켜야 할 것으로 생각된다. Purpose: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. Methods: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. Results: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. Conclusion: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.

      • KCI등재

        우리나라 전공의 수련교육 구성 및 운영에 대한 제안

        허정식,Huh, Jung-Sik 연세대학교 의과대학 2018 의학교육논단 Vol.20 No.3

        In clinical clerkships, residents function as trainees, workers, and teachers for other medical students. Although residents care for patients in harsh environments and encounter precarious patient-safety situations, they are working towards becoming competent specialists. Residency education programs are very important in cultivating specialists able to adapt to the rapidly-changing medical environment, and are also necessary to improve the quality of specialist training. Competent specialists not only need clinical competency, but also a wide range of abilities including professionalism, leadership, effective communication, cooperation, and attention to continuous professional development/continuing medical education activities. Each Korean association of specialties has its own educational goals and standardized education programs to help residents learn specific techniques and competencies related to medical care for patients, though the training environment of each residency is different within each trainee hospital. Although it is also important to evaluate residency education programs, currently there is only an examination of knowledge and assessment of skills based on mini-clinical evaluation exercises or direct observation of procedural skills. In order to develop an objective and estimable evaluation tool that can assess the overall achievement level within each training course, it is necessary to evaluate the knowledge, skills, and attitudes of residents. Residency education programs need further attention and reform.

      • 제주의 의료분쟁판례분석

        허정식,김기영,Huh, Jung-Sik,Kim, Ki-Young 제주대학교 의과학연구소 2019 The Journal of Medicine and Life Science Vol.16 No.1

        Medical disputes can always arise in the medical environment. We aimed to decrease the medical disputes by analysis for causes and results of cases of medical disputes. The cases of medical dispute were found on the homepage of the Supreme Court based on the judgment data which was searched using the keyword 'Jeju, Medical accident' and it was described as the area related to each medical accident. There was total of 13 cases related medical disputes in Jeju. The final states of the patients were different in each causes, but death accounted for 10 cases (76.92%), comatose state for one and disability for two respectively. The cases were 2 related with an injury from a fall. The major cause was violation of medical care obligation. Physician have to learn recent medical knowledge, have competence, and explain the detailed procedures and complications before the procedures dependent on patient autonomy.

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