1
4 4 4 (Tw-DRGs) 8 8 22 ( ) 22 ( ) 30 ( ) 51 ( ) 65 ( ) 69 ( ) 87 ( ) 82 ( ) 86 ( ) 90 ( ) 99 () 104 () 109 () 113 () 118 () 121 () 123 () 124 Tw-DRG 126...126 DRG... 130 MDC2 130 MDC5 131 MDC6 133 MDC8 137 MDC12 141 MDC13 142 2
MDC14 145 178 186 195 207 214 219 228 230 234 237 245 248 253 255 260 264 265 266 303 313 3
100 10 03 1000075850 * (100/11/1)() (100/11/1) ( ) 1. (100/11/1) 2. 12 ( 4
) (100/11/1) ( ) 1. (100/11/1) ( ) 1. (100/11/1) 2. (100/11/1) ( ) 1. (100/11/1) 2. (100/11/1) 3. (1) ( 5
) (100/11/1) (100/11/1) (2) (100/11/1) (3) (100/11/1) (4) (100/11/1) 4. (100/11/1) 5. (100/11/1) 6
(100/11/1)() 1. (1) (2) (3) 2. (1) (2) 3. (1) (2) 4. (1) a b OD OD c O.D d O.D e O.D f O.D. g O.D. h O.D. a. 5% b. 1% (2) 5.(1) 1% (2) 7
(100/11/1)() 84 9 19 84016569 85 2 16 85001960 86 1 4 86000060 87 4 15 87007495 89 6 9 89015284 91 12 20 0910023538 93 4 7 0930068296 94 2 25 0940068620 95 1 9 0940069098 95 7 7 0950068550 96 3 12 0960062072 97 4 1 0970012154 97 4 16 0970012203 97 7 18 0970012454 98 2 12 0980032057 98 6 18 0980095034 98 12 14 0980095828 99 2 25 0990074102 99 5 31 0990051357 99 12 6 0990082225 100 3 29 1000075057 100 10 03 1000075850 * (Tw-DRGs) ( )(99/7/1) ( ) 1. 2. 3. 4. 5. 6. 7. 8
8. 9. 1. 8. (99/7/1) ( ) ( ) ( ) 1. 2. 3. 4. 5. 6. 7. 8. 9. 9
10. 11. 12. 13. 14. 15. 16. 17.(99/7/1) ( ) ( ) ( ) ( ) 1 cephalothin, cefazolin, cephradine, cephaloridine, cephapirin 2 cephamycin cefamandole, cefonicid, cefuroxime, cefotiam 10
3 Cephamycin cefoxitin, cefmetazole 4 Pseudomonas cefotaxime, ceftizoxime, ceftriazone, cefmenoxime 5 Aminoglycoside tobramycin netilmicin 6 Fluoroquinolone norfloxacin, ofloxacin, enoxacin, ciprofloxacin 7 Glycopeptide vancomycin teicoplanin 8 β-lactamase inhibitor Augmentin Unasyn ( ) ( ) 1.( ) (99/7/1) 2. () 1. 20% 1 1 13007C 11
13016B 2. 3 3 3. () () 1. 2. (1)( ( ) (2) 12
(3) (4) 3. 4. (97/5/1) (100/11/1) () () () () () 1. (1) A. 13
B. C. D. ()( ) E. (2) A. B. C. D. ()( ) E. (procedure of choice) 14
(procedure of choice) (99/7/1) () (95/7/15) () (98/3/1) ( ) (95/7/15) 1. ( 1. 2.malignant ) arrhythmia 3. 2. 1. 15
2. 3. 1. 1 2 3 4 5 2. 4. 1. 1 2 3 4 5 2. 16
5. 1. 24 2. (1) (2) (3) (4) (5) 3. (1) (2) (3) (4) (5) 17
6. 1. 1500 2. 3. 4. 5. 18
( ) (DNR) DNR (97/5/1) ( ) ( ID ) (97/5/1) ( ) (99/1/1) (100/11/1)() ( ) 1. 2. 3. 4. 5. 6. 29 ( )83079BRadiofrequency coagulation(rf) 19
1. (1) Image-guided OP note (2) 3 (3) (image-guided diagnostic block) 2 RF 2. (1) (Facet Joint Syndrome) (2) (3) Neuropathic painpostherpetic neuropathic pain (4) Failed Back Surgery Syndrome,FBSS(Chronic spinal pain) 3. (1) 6 3-6 (2) 20
(99/7/1)(100/5/1) 21
( ) 1. (1). (2). 97/6/1 10.2 Penicillins & 10.3 Cephalosporins (100/1/1) (2) (100/1/1) (3) (100/1/1) (3). (4). 22
48004C 48006C 48022C 48024C 48033C 48035C Balance Salt Solution Physiologic Irrigating Solution 23
64141C 64274C64275C A. ( ) 69014B 69015B ( ) 69019B (C) ( ) ( ) 69019B 1 + 69014B 1/2 B. 69014B 69015B C. 69016B 69017B 2. (1). IV Push 57111C (2). 24
(3). 19005B (4). (5). (6). (7). (8). (97/5/1) (9). (10). (11). tocolytics β-mimetics (12). (13). 25
(vial) (ampoule) 14. (54019C 54027C 54037C 54038C) (99/7/1) 3. () (1). (2). ( ) (3). (4). (5). (6). (7). 26
(8). IV Push 4. (1). 5. 6.(1) (100/1/1) X (100/1/1) (3) (100/1/1) (2) (3) 7. (1) ( ) (2) 27
A. KARNOFSKY SCALE() ( ) ()60 ( ) B. C. D. (A) (B) (C) A. B. (3) A. B. ( ) ( ) C. 28
D. E. A. B. 1. ( ) 1. 2. 3. 4. 5. 6. 7. 8. ( ) (99/7/1) 29
( ) 1. (1) (2) (3) (4) (5) (6) MRI CT (7) (8) ( ) (9) sulfonylureas (glimepiride ) meglitinides ( repaglinide nateglinide) (10) ACEI ARB 30
potassium-sparing diuretics aldosterone antagonist -blocker pacemaker-blocker (5) thiazide diuretics (99/7/1) (6) ACEI (99/7/1) thiazide diuretics (11)serotonin antagonist (12)TZD thiazolidinedione (IGT) 3 6 HbA1c metformin metformin TZD (97/5/1) (13) 90 (97/5/1) 31
(14)(47020C) (97/5/1) 2. (1) (2) IV Push (3) (4) (5) (6)GOT GPT HBSAG Anti HCV Anti HBS ( B ) (99/7/1) (7) CCr 10 ml/min UF<2.0 CCr (97/5/1) Ccr 24 Cr measured Ccrestimated Ccr CG-GFR Cockcroft-Gault =140-Age Bwt / 72 Cr 1.73/ BSA 0.85 if female 32
MDRD-Simplify-GFR=186 Scr 1.154 Age 0.203 0.742 if female (97/5/1) ( ) A. Cr 6.0 CCr 5ml/min Ccr 24 CG MDRD (97/5/1) B. UF<2.0 40 5 C. A. B. BMI data C. residual renal function CCR D. Albumin E. (8)BC ALT ( bilirubin >2mg/dL, PT prolong>3 sec) BC HBV DNA HCV RNA B 6 12 HBV DNA C ( RVR) 6 HCV RNA 6 (99/7/1) 33
3. () (1) (2) ( ) (3) (4) (5) (6) (7) (8) IV Push 4. 34
5. (1)EPO ( ) (2) Kt/V Kt/V 1.7 50 /1.73 (100/5/1) (3)(98/3/1) 09041B 17002B Pimax and Pemax ( ) Try weaning (97/5/1) 35
17007B 1. (flow volume curve) flow volume curve 2. 3. 17007B 17003B 17004B 4. 17017B Try weaning (97/5/1) 47045C 1. 47045C (1) (2) (3) 2. x (99/7/1) 3. 4. (99/7/1) 56022C 1. 2. 57007C 57009B ( ) 1. manual resuscitation-bag 2. 57012B ( ) 1. (57011B) 36
57015B 57016B 57017B 57018B ( ) ( ) ( ) ( ) (1) (2) 2. (57010B) (1) COPD (2) (3) 3. (57012B) (1) (2) (3) 1. 2. 37
57021C 57022C 57024B ( ) ( ) ( ) 1. COPD,bronchiectasis, asthma,pneumonia ( ) 2. 57024B 3. 57024B 57021C 57022C (99/7/1) 1. MDI COPD,bronchiectasis,asthma,pneumon ia ( ) (99/7/1) 2. 57024B 57021C 57022C (99/7/1) (4) 47032B 47033B 57017B 57018B (5) (97/5/1) (6) () 38
(7) 8. ( 33076B-33078B) ( 18020B-18022B) ( 18020B-18021B) 18022B(99/7/1) (9) (97/5/1)(99/7/1) (10) (11) 18005B() 18006B( ) 18007B( ) 18007B 18006B (3)18007B 1 2 3 4 5 6 (99/7/1) (12) 26025B 39
(26024B) (26025B) A. B. C. D. - E. F. G. H. I. J. K. L. (26024B) A B 40
A. B. (13) (single lumen) 47015B( ) (double lumen) 69006C( ) (14) UGI series (15) 17003C 17006B 17007B 17019C 17003C 17006B 17007B, 17006B 17019C (97/5/1) (16) 18024B 18025B (17) (97/5/1) 41
(18) EPO ( ) (19)(CAVH) 58007C (1) (2) (3) severe volume overloading (20) (21-1) (96/4/1) (21-2) (96/4/1) (21-3) -- 19009C (96/4/1) (21-4) B C 3 -- 19009C (96/4/1) (22) 1 (97/5/1) (23) Port-A 48010C 42
(24) (WBC 1,500 50,000) 08011C (25) ( 3000cc ) 93008C 94201B94202B 94001C (26) A. B. C. D. A. () B. (27) 97/9/1 A. - B. - 97/9/1 43
A. -- B. -- C. --SMA D. -- E. F. (A) ( ) (B) -- A. - ( ) B. - ( ) C. - D. - A. -( ) B. - C. - 44
D. A. - B. - C. - D. IV pump RCW180 243 97/9/1 (28) (96/4/1) 1 1 ( ) 14 14 (99/7/1)(100/1/1) 45
(29) (96/4/1) A. (/ (69006C) (47059B 47061B)): CCr 15 ml/min (Cr) 6.0 mg/dl A., B.,C.,D.,E.,F.,G.,H. (cachexia),i. (BUN > 100 mg/dl) B. (A) 69032C (B)69034C (C) 47059B 47061B 46
C. (A) a. CCr 15 ml/min b. (Cr) 6 mg/dl c. (B) (AV graft) a. CCr 12.5 ml/min b. (Cr) 7 mg/dl c. (C) (AV graft) a. CCr 10 ml/min b. (Cr) 8 mg/dl c. (D) 30 (Cr) 6 mg/dl 4 (Cr) 5 mg/dl D. A. 58012B 47
B. (A) CCr 15 ml/min (B) (Cr) 6 mg/dl (C) C. (A) CCr 10 ml/min (B) (Cr) 8 mg/dl (C) D. 30 (Cr) 6 mg/dl 4 (Cr) 5 mg/dl (30) (97/5/1) (31) 17008B 57018B (97/5/1) (32), (56010B) (97/5/1) (33) (97/5/1) Total recording time 6 MSLT total recording time total sleep time sleep efficiency sleep onset latency REM latency sleep 48
stages histogram apnea-hypopnea index AHI respiratory disturbance index RDIperiodic leg movement index arousal index CPAP PSG AHI RDI 15/H 5 RDI 15/H Titration Chart (34) (97/5/1) CBC (35)(FFP) (97/5/1) 49
21 22-42 43-63 63 50
( ) 1. 2. (1) (2) (3) 48014C 48017B 48018C 48021B (98/3/1) (4) 48014C 48021B (98/3/1) (5) 48014C 48018C 48013C 48018C (6) (7) (8) 48004C~48006C 51
48022C-48024C 48033C-48035C 3. 4. 5. 6. balance salt solution physiologic irrigating solution 7. (62032B 62036B) 8.( ) ( ) (Split thickness skin graft) 9. 10. 11. 72032B 72046B 72047B location 16 12. 52
( 1. ( N1 N2 ) (N1 N2 nodes) 15 2. ) 13. (1). -- 69014B 69015B. -- 69019B. -- 69019B 1 + 69014B 1/2-- (2) 69014B 69015B (3) 69016B 69017B 14. 69032C ) (99/7/1) 15. 16. 53
17. (1) (2) 18. (1)- 2 62010C 62009C (2) 64087C( ) 19.(clean wound) (open drainage) (infected wound) 20. 21. 22. ()(49004C) 49004C 48013C 23. 54
24. 83048C 25. 26. (1) (2)Danzen Varidase 27. 28.73011B 73012B 73012B 29. (1) (68025B) 68025B (2) 30. 31.(51020C) 32. (64116C) 55
(62010C) 33. (48001C) (56006C) 34. (64140C) 35. 36. (1) (2) (3) periappendicitis,fecalith,congestion 37.IV PUMP SET (1) heparin,dopamine levophed IV PUMP (2) intake output TPN IV PUMP (3) 10 10 38. (1) 56
(2) 39. 40. 41.(18008B) (1)(PAOD) (2) (IABP) (3)(ECMO) (4) (5) 42.RH(D) (11003C) 57
(1)Rh0(D) (2) 43.(75401B)(19006B) (19007B) (1)(75401B).....( ) (2) (19006B) (3)(19007B) 44.(29017C)(33026B) (1)(29017C) (2) (33026B) X 58
.... 45.(78607C 4550 ) 46. tendon repair 47.(64208C) 10 48.(gastric partition)72035b (1)BMI(body mass index) 40kg m2 BMI 35kg m2 ) (2).. 18~55... 59
49. (95/7/15) (1) 10 2 A. (A)B (B)C (C) (D) (E) (F) B. (A) Alagille Byler (B)PFIC progressive familial intrahepatic cholestasis (C) (D) (E) a. cystic fibrosis 60
b. nonsyndromic paucity of intrahepatic bile duct C. (A)Wilson (B) (C)Tyrosinemia D. (A) urea cycle defect (B)amyloidosis (C) E. (A) hepatocellular carcinoma (B)hepatoblastoma (C)hemangioendothelioma (D) (E) F. G. H. AASLD (A)Budd-Chiari syndrome (B)metastatic neuroendocrine tumor (C)polycystic disease (D) I. 65 65 65 61
A. (A) total bilirubin>3mg/dl (B) total bilirubin>10mg/dl B. 3 C. 2 D. Grade2 2 E. F. INR>1.5 G. H. BW<3 percentile I. Child B (A) Milan criteria (B) UCSF criteria J. (diffuse-type hepatoma) K. L. M. 62
50.FTSG ( ) 2/3 (STSG) FTSG 80(97/5/1) 51. 48014C 48018C 25 0.5%TBSA(Total body surface area) (97/5/1) 52.(74417C) : (97/5/1) (1) (2) (3) (4),,, 53. (97/5/1) 54. (47059B) Port-A (47080B), (69005B) 15( ) (97/5/1)(99/7/1) 55. 47049B (99/7/1) 56. 62001C 1 63
62002C 1~2 ( ) (99/7/1) 64
( ) 1. (1) (2) (3) 10.2 Penicillins & 10.3 Cephalosporins (100/1/1) (4) (97/5/1) (5)( ) (6) (7)(97/6/1) 65
(100/1/1) (100/1/1) A B C ( ) (8) (9) (48011C) (10)() (11) 14 (100/1/1) (12) Nebulizer (100/1/1) 66
(13) O2 tent O2 hood (57014B) (14) (30022C) IgE 2. (1) (2)( ) 3. (1) (2) 4. (1) ( ) (2) 67
(3) (4) (57009B) AMBU bag 57009B IMV Resuitator( ) IMV 57009B( ) (5) postural drainage(47045c) (97/5/1) 68
( ) 1. (1) (2) (3) (4) (5) 55010C 2. (1) (2) (3) (4) 69
(5) 96004C 6. (99/7/1) 3. (1) (2) (3) (97/5/1) (4) (5) (6) (tocolytics) ()( ) (7)Clomiphene citrate 4.(80403B)(80412B) 70
(80413B) (1)80403B (2)80412B (parametrium) (3)(80413B) (80414B) 70208B 5. (1) (2) 6. 7. 71
8. ( ) 9. (1)13006C (2)16007C 10. 1. 2. (80403B) (80404B) 3. (99/7/1) 11. (1)Fetal distress( ) (2)Failure to progress in active labor() (3)APH(placenta previa, equel te placenta)() 72
(4)Malpresentation(including twin with malpresentation)( ) (5)Cord equel te() (6)Induction failure( ) (7)Active genital herpes() (8)Previous C/S( ) (9)Previous uterine surgery() (10)Vulvar and/or vaginal condyloma equel te,diffuse( ) (11)Treatable fetal anomalies(e.g. gastroschisis,omphalocele,hydrocephaly)( ) (12)Preeclampsia with() uncorrectable severe preeclampsia HELLP syndrome with failed induction(6hrs) eclampsia with poor induction progress(6hrs) (13)Extremly premature fetus < 1500gm( NICU ) (<1500 ) (14)Pelvic deformity(equel of poliomyelitis or traffic accident,etc.)() (15)Fetal macrosomia(>4000gm EBW)(>4000 ) 73
(16)Cephalopelvic disproportion (CPD)( ) (17)Obsructive labor(e.g. myoma,ovarian tumor) ( ) (18)Major medical complications( ) (19) HIV(+)(98/8/1) (20) (98/8/1) 13. MTX 14. (101/2/1) () 15. (101/2/1) () 16. (28014C) 17. (18013C 18014C) 18035B 18. 74
19. 20. (1) (D&C) (2) (D&C) (3) (4) 21. urine acetone 22.Folliculometry 23. 24. Ketoconazole Mycostatin 25. IUD IUD displacement 26. PAP smear () 27.C/S (ATH, VTH ) 75
(1)C/S (ATH, VTH ) (2)(ATH, VTH ) 28. (97/5/1) 29. (1) (2) 30. (1) (D&C) (2) (D&C) (3) (4) (101/2/1) () 31. 32. 33. 34. Pulse or ear Oximetry(57017B) 76
(47031C) 35. conization 77
( ) ( ) Gardnerbipolar prothesis Karnofsky Scale X-ray (100/1/1) 2. 3. 1. 2. 30% 3. 50% 4. 20 5. 6. 23 4. (cross link) ( )( ) 3 ( )( ) cross link( ) cross link 5. ( )(THR TKR) (custom-made) 78
(99/7/1) 7. k pin 8. 8. (97/5/1) 10.()( ) 11. 1. multiple fracture(2 components ) 2.open fracture 3.pediatric fracture 4.complications neuro vascular injury visceral organ injury infections etc 5.joint fracture or joint dislocation (101/2/1) 6.special condition femoral neck fracture 12. CRP ESR 13. 79
(1)59007B (97/5/1) (Mader-Cierny II B ) (2)() (3) A B 14. 15. 16.( 33054B-33058B) 17.,,, 80
64243B( ) 64244B( ) 28001C( ) (97/5/1) 18. (101/2/1) 19. (101/2/1) 81
( ) 1.(79404B 79405B 79406B 79411B 79412B 97401K 97402A 97403B) (1) (97/5/1) (2) BPH (3) (4) 78026C (5) 5 79407C (97/5/1) 2. (1) (2) (79407C) 3. (1) ( ) U.V.J. stone ( )(78026C) ( ) U.V.J.stone 82
(99/7/1) (2) (3) (ESWL)(50023B 50024B 97405K 97406A 97420B 97407K 97408A 97421B 97409K 97410A 97422B 97411K 97412A 97423B) A B 1.KUB Sono 2.IVU 3.RP ESWL ESWL 0.5cm( 0.5cm ) () 4. PGE1 20mcg ( )Gn-RH Analogue staget3 N1 M1, PSA CT Scan MRI Bone Scan 83
(97/5/1)(99/7/1) 6. Video-urodynamic study (21006B) (21004C)(21007C)(21003C) 7.(50019C) 8. (05221A) (50011C) (37005B) 05221A 9. (50020C)(97/5/1) (1) (paraphimosis) (2) (3) (4) (5) 10.BPH bethanechol (97/5/1) (1)BPH bethanechol finasteride -blocker 3 (2) on Foley 84
detrusor (3) DM 1 (4)DM AUR (5)NB neurogenic bladder urinary retention on Foley 11.ESWL URS, (97/5/1) 12.,. (97/5/1) 13. -J,(97/5/1) 85
( ) 1. 2. (54023C) 3.(57007C) (57021C) 4. (56019B )(56019B ) 5. ( ) 6. parotidectomy (71015B) (71019B) (71020B) (83030B) 7. 8. - 86
(54019C)- (54027C) (54037C) (54038C) (97/5/1)(99/7/1)(100/1/1) 9. (65035B) 10. SMT UPPV (101/2/1) () 11. (1)(65072B) 90 (97/5/1) (2) (65074C) (3)()(65003C) (4) 12.(22008B) (22001B) 87
13. (1)28002C nasopharyngoscopy) (28003C sinoscopy) (28004C laryngoscopy) 1 FESS( )sinuscope (97/5/1) (100/1/1) ( ) (99/7/1) (2) stroboscopy. (28005B) (3) Laryngoscopy (28004C) Stroboscopy(28005B) (4) rigid ventilation bronchosocpy (67012C) (5) 88
(99/7/1) (6) (99/7/1) 14. 15.(1)(VFT) Nann Romberg VFT (2) (3) 16.() ()(97706K 97707A 97708B)( ) (97/5/1) 17. ( )(97701K 97702A 97703B) ( ) 89
( ) 1. ( ) 2. (85204C) (1) () (2) 5mm (3) 3. (1) (2) 4. (1) (101/2/1) () (2) (101/2/1) (3) 90
(4) (23401C) DBR (A )(23503C) (23001C) (5) (6)( )(86008C) (86009C) (86010B) (7) (86012C) (86012C) (86013C) (8) carbamycholine acetylcholine chloride 1% (9)(101/2/1) () (10) (97/5/1)(99/7/1) (11) (101/2/1) () (12) 91
(101/2/1) (13) (99/7/1) (14) ( )(85205C)( 90 2 27 90006127 ) (15)( ) ( ) ( 90 2 27 90006127 ) 5.(97/5/1) (1) ( ) (2) (3) ( ) (4) 92
(5)(23702C) (PRP) 23702C( ) (6)( FAG Fluorescein Angioraphy) ( 90 2 27 90006127 ) (7) (86207B)1/2 (85608B) ( ) (85608B) 1/2 (86206B) ( ) (85608B)( ) (86404B) (86403B) 6.(86206B) 93
(86207B) (1)86206B (2)86207B 7. (1) (85213B) ( )(85213B)1/2 ( ) (86008C) (2) 8.(1) (101/2/1) (2) (23201C) (23202C) (23203C) (23204C) (23205C) (23206C)(23207C) (23208C) 9.(60001C 60014C) (1) (60003C) (60004C) X2() 60003C 60004C (2)() (60005C)() 94
(60006C) 60005C 60006C (3) ( ) (60007C) ( ) ( 60008C ) X2 60007C 60008C (101/2/1) (4) ( ) (60011C) ( ) (60012C)YAG 60011C (5)(60013C) (6) (7)(60001C) (60002C)(60003C) (60004C) () (60005C) () (60006C) (8) (9) (Laser Peripheral Iridoplasty)( ) (60011C 60012C)(Laser Membranectomy) (Laser Traction Fibrotic Vitrectomy) (60013C 60014C) (99/7/1) 10. 95
11. (1) ( ) (2) (3) (4) ( 90 2 27 90006127 ) (5) (6) 12.23706C (23401C) 13. 23803C (1)(23702C) (23501C) (2) (3) (4) 14.(53024C) ( 9 (97/5/1) 15. 2.0D (23001C) 96
(97/5/1) 16.(1) 2 (2) (97/5/1) 17. (97/5/1)(99/7/1) 18. (23305C) (97/5/1)(99/7/1) 19. (85201C) 20. (53016C) 21. ( 90 2 27 90006127 )(99/7/1) 22. ( 90 2 97
27 90006127 ) 23. ( 90 2 27 90006127 ) 24. ( 90 2 27 90006127 ) (99/7/1) 25. 53010C 85205C K-reading (97/5/1) 26.(87004C 87005C 87017C) (99/7/1) 98
( ) 1. (1) (97/5/1)(99/7/1) (2)(51018B 51019B); 2.(51017C)(51021C) (51022C)(95/7/15)(99/7/1) (1)51017C 3 ( ) 2 2cm 2 (shaving) (2)51021C 1 2 1cm (3)51022C 2 1 2 2 1cm 2cm 2 (4) 51017C (99/7/1) (101/2/1) 3. 4 (51009C) 4-9 (51010C)9 (51011C) (1) () 99
(2) (97/5/1) 4. 1. (1)(51005C) (2)(51006C) 2.(99/7/1) 5.(51020C) (abscess) ( ) (51004C) 6. 7. (1) (2) (3) 8. () 100
9. 10. 11. tranexamic acid 12. Sporanox (itraconazole) Lamisil (terbinafine) azole allylamine 13. 14.(CO2 laser operation)62020b (1)Nevus sebaceous( ) (2)Epidermal nevus() (3) (Periungal warts) 5 ( ) 2 (97/5/1)(99/7/1) (4)Precancerous lesions include actinic keratosis, oral ) (5)Lichen amyloidosis( ) (6)Hemangioma( ) (7)Skin cancers( ) (8)Mibelli (porokeratosis) 101
15.Acne therapy 51004C ( ) 16. 0940068849 (1) ( ) (2) 50 (3) 3 30 100 (4) PUVA (5) T ( en plaque) PLC PLEVA) (6) (GVHD) PUVA UVA1 (7) 102
17. Antihistamine() 2 103
() 1. (1) (2) (3) (4) 2. (1) (2) (3) 104
( ) (4) (5) (6) (97/5/1) (7) IV Push (8) 3. (1) (2) CT MRI (3)(37028B 37029B 83081B 83082B 83083B 83084B)() 105
(4) (5) 20013B() 20021B( ) (101/2/1) A B (TIA) (6) 20026B() ( TIA) (101/2/1) 4. NCV F-wave H-reflex EEG (1)(20015B 20016B 20019B) (2)H-reflex (20024B) 106
spasticity (3)F-waves (20023B) (4)EEG(20001C 20002C 20004B 20005B 20006B) A B C D E F G H I 107
A B C D(99/7/1) E A B C D E Alzheimer disease R/O Jakob-Creutzfeldt disease Jakob-Creutzfeldt disease R/O Alzheimer disease (5) 108
() 1. (1) maep ILOC (Injury induced Loss Of Consciousness) Skull fracture IICP sign GCS 3 IICP sign (99/7/1) (2) Skull X-ray CXR EKG Blood Routine PT PTT GOT GPT BUN Cr Na K Sugar Brain CT Skull view C-spine pelvis (3) Contaminated deep wound Clean-wound surgical wound 3 Superficial abrasion contusion 109
2. coma scale T.P.R coma scale T.P.R 3. CT MRI brain concussion 3 5 4. Pulse Oximeter Arterial Blood Gas 1 1 5.Perineal care Foley care indication routine 6.Specific gravity ICU care D.I. order 7. 8.Diprivan 1 9. (1)delayed ICH () CT scan recurrent ICH 110
complication 1/2 (101/2/1) (2)Spinal stenosis Laminectomy()Discectomy Discectomy 1 Laminectomy 1/2 (3)Open depressed fracture+ich ICH depressed fracture CT Scan (4)Transsphenoidal surgery SMR1/2 Bone Graft 64002B 62009C 10. (1) 3 20 Karnofsky performance scale(kps) 70 ECOG 0-1 (2) (3) 94/2/25 11.NCV/EMG CT/MRI NCV/EMG CT/MRI ( Neuropathic pain 111
) (97/5/1) 12.Disectomy Laminectomy Laminectomy endoscope surgery Laminectomy (97/5/1) 112
() 1. 2. (45040C) 45037C 45070C 3. 4. (1) (2) 5. 113
(95/7/15) (1) ( )(45094C) (2) supportive individual psychotherapy 45010C (99/7/1) (3) re-educative individual psychotherapy 45087C 45088C 45089C) (99/6/1) (4) 40 intensive individual psychotherapy 45013C 45090C 45091C 114
A. B. (99/7/1) C. D. 40 (5) supportive group psychotherapy 45016C (99/7/1) (6) intensive group psychotherapy 45019C 90 (2) (3) (4) 115
(5) (99/7/1) 6. (45019C) 7. (45079C) 8. 9.(45046C 45098C 45099C) (95/7/15) 10.(45055C) 11.(45049C) 12. (45102C) 116
13. (95/7/15) 14.( )(97/5/1) 15. 25 (97/5/1) 117
() 1. 2. ( ) (100/1/1) 3. ( ) 4. (1) () ( - ) (2) 5. (97/5/1) 6., 7. (101/2/1) () 8.( )( ) 118
9. 51018B 51019B 10. 47039C -- 11. 12.(101/2/1) 13.43010C 43023C 14. 41005C 15. 41006B 16. 42016C 42016C ( ) (98/3/1) 17. 119
( ) ( ) (98/3/1) 18. ( ) (98/3/1) 120
() 1. (1) (2) ( ) 2. 3. 4. 5. 6. 7. ( PTCD ) 8. 36011B 36012B 9.36012B (97/5/1) 10. (19014C)(33005B) 121
11. X (37028B) (37029B)(36015B) (36021C) 12.(37026B) 30 13. 36001B 36018B 122
() 1. (25001C) (25002C)(25003C) (25004C)(25024C) (25025C) 25003C 25004C 2. 3. 123
() 1. () (Pulse Oximeter) (57017B) 2. 3. 4. 5. 6. (96025B)(96026B) (97/5/1) 7.96003C ( ) 8. (IV IM anesthesia)(96004c) 9.96004C short induction barbiturates( thiopental methohexital) Etomidate Ketamine Propofol ( )( ) 10. 124
() 11. 12. 96011C 13. 2 2 10 15 (96/4/1) 125
(Tw-DRGs) (99/1/1) ( ) Tw-DRGs ( )Tw-DRGs 1.() 2. 3. 4. 5. (Outlier) 6. 7. ( ) 1.Tw-DRG ICD-9-CM 2001 2. (1) (2) ( ) (3) 126
3. (1) (Clinical Evaluation) (Therapeutic Treatment) (Diagnostic Procedures) (Extended Length of Hospital Stay) (Increased Nursing Care and/or Monitoring) (2) 4. (1) (2) (3) 5. Tw-DRG 6. Tw-DRG 127
7. Tw-DRG 8. significant procedure ( ) 1. (1) (2) 2.(99/4/1) 3. (99/4/1) (1) 24 (2) (complication) (99/4/1) 128
(3) (4) ( ) (5) (99/4/1) (6) (7) ( ) ( )Tw-DRG (100/5/1) ( )Tw-DRG () (100/5/1) 129
DRG (100/11/1) MDC2 DRG03904 (BILATERAL LENS PROCEDURES WITHOUT VITRECTOMY) DRG03905 (UNILATERAL LENS PROCEDURES WITHOUT VITRECTOMY) ( ) 1. 2. 3. 4.( ) 5. ( )() 1. ( )( ) ( ) 2. ( ) DRG 1. 2.. 3. 4. 130
MDC5 DRG11201 (MULTIPLE VESSELS AND OTHER PERCUTANEOUS CARDIOVASCULAR PROCEDURES) DRG11202 (SINGLE VESSEL PERCUTANEOUS CARDIOVASCULAR PROCEDURES) DRG11203 (CATHETER ABLATION OF LESION OR TISSUES) DRG11204 (OTHER PERCUTANEOUS CARDIOVASCULAR PROCEDURES) ( ) 1. 2. ( )() 1. 2. 理 ( ) 狀 ( ) 療 療 ( ) 路 律 不 ( ) ( ) 3. ( ) DRG ()( ) 1 1. 2.24 3.(stress testing) ( ) ( ) 201 ( ) 131
( ) ( ) 4. 5. ( ) DRG 1. 2. 3. 132
MDC6 DRG16101 18 (BILATERAL INGUINAL AND FEMORAL HERNIA PROCEDURESAGE 18 WITH CC) DRG16201 18 (BILATERAL INGUINAL AND FEMORAL HERNIA PROCEDURESAGE 18 WITHOUT CC) ( ) 1. 2. 3. ( )() 1. 2. ( ) DRG 1. 2. 3. 133
DRG16102 18 (UNILATERAL INGUINAL AND FEMORAL HERNIAPROCEDURES AGE 18 WITH CC) DRG16202 18 (UNILATERAL INGUINAL AND FEMORAL HERNIAPROCEDURES AGE 18 WITHOUT CC) ( ) 1. 2. 3. ( )() 1. 2. ( ) DRG 1. 2. 3. ( ) () 134
DRG16305 0-17 (UNILATERAL HERNIA PROCEDURES AGE 0-17 WITH CC) DRG16306 0-17 (UNILATERAL HERNIA PROCEDURES AGE 0-17 WITHOUT CC) ( ) 1. 2. 3.0-17 ( )() 1. 2. 6 ( ) DRG 1. 2. 3. ( ) () 135
DRG16401 (LAPAROSCOPIC APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC) DRG16501 (LAPAROSCOPIC APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC) DRG16402 (APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC) DRG16502 (APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC) DRG16601 (LAPAROSCOPIC APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC) DRG16701 (LAPAROSCOPIC APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC) DRG16602 (APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC) DRG16702 (APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC) ( ) 1. fecalith congestion hyperemia phlegmonous 2. acute suppurative appendicitis ( )() ( ) DRG 1. 2. 3. 4. 136
MDC8 DRG20901 (REVISION OF HIP REPLACEMENT WITH CC) DRG20902 (REVISION OF HIP REPLACEMENT WITHOUT CC) ( ) ( )() 1. 2. 3. 4. 5. (CRP ) 6. ( ) DRG 1. 2. 3. 137
DRG20907 (REVISION OF KNEE REPLACEMENT WITH CC) DRG20908 (REVISION OF KNEE REPLACEMENT WITHOUT CC) ( ) ( )() 1. 2. 3. 4. (CRP ) 5. 6. ( ) DRG 1. 2. 3. 138
DRG21002 18 (HIP AND FEMUR PROCEDURES WITH PDX OR SDX OF INFECTION, EXCEPT MAJOR JOINT,AGE 18 WITH CC) DRG21003 18 (CLOSE FRACTURE AND OTHER DISEASES AND DISORDERS OF THE MUSCULOSKELETAL S YSTEM AND CONNECTIVE TISSUE HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT,AGE 18 WITH CC) DRG21102 18 (HIP AND FEMUR PROCEDURES WITH PDX OR SDX OF INFECTION, EXCEPT MAJOR JOINT,AGE 18 WITHOUT CC) DRG21103 18 (CLOSE FRACTURE AND OTHER DISEASES AND DISORDERS OF THE MUSCULOSKELETAL S YSTEM AND CONNECTIVE TISSUE HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT,AGE 18 WITHOUT CC) DRG21904 (2) 18 (CLOSE FRACTURE AND OTHER DISEASES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT,FEMUR(1) AGE 18 WITHOUT CC) DRG22404 (CLOSE FRACTURE AND OTH ER DISEASES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE SHOULDER, ELBOW OR FOREARM PROCEDURES WITHOUT CC) ( ) 1. ( ) X ( )Open fracture 2.( ) 139
( )() ( ) DRG 1. 2. 3. 140
MDC12 DRG336 (TRANSURETHRAL PROSTATECTOMY WITH CC) DRG337 (TRANSURETHRAL PROSTATECTOMY WITHOUT CC) ( ) DRG 1. 2 2 ( )IPSS( ) 8 ( )UFR Qmax( ) 15 / ( ) 20 2. ( ) 1. 2 2 ( )IPSS 8 ( )UFR Qmax 15 / ( ) 20 ( ) ( ) ( ) ( ) ( ) 2. PSA 3.5 5 79407C ( ) DRG 1. 2. 3. 141
MDC13 DRG35802 (LAPAROSCOPIC HYSTERECTOMY WITHOUT INCONTINENCE WITH CC) DRG35902 (LAPAROSCOPIC HYSTERECTOMY WITHOUT INCONTINENCE WITHOUT CC) DRG35804 (HYSTERECTOMY WITHOUT INCONTINENCE WITH CC) DRG35904 (HYSTERECTOMY WITHOUT INCONTINENCE WITHOUT CC) ( ) ( )() hysterectomy 1.Leiomyomas Leiomyomas (hysterectomy) ( )abnormal uterine bleeding ( )pelvic pain ( )pelvic pressure ( )others ureteral compression uterine growth after menopause rapid growth 2.Dysfunctional Uterine Bleeding ( ) 3 3 3.Intractable Dysmenorrhea 142
3 3 4.Chronic Pelvic Pain uterine origin (nonsurgical) 3 3 5.Cervical Intraepithelial Neoplasia CIN hysterectomy pap smear biopsy conization.recurrent high-grade dysplasia.cin 3 at limits of conization()specimen.poor compliance with follow-up 6.Genital Prolapse symptomatic prolapse feeling of pressure something is protruding from the vagina low backache feeling of heavinessetc. 7.Obstetric Emergency ( )postpartum hemorrhage ( )uterine rupture that can not be repaired ( )placenta accreta increta percreta ( )others 8.Pelvic Inflammatory Disease plevic abscess with uterine involvement 9.Endometriosis conservative surgical treatment( resection or ablation of endometrial implants) 10. ( ) DRG 1. 24 2. ( ) 3. 4. 143
( ) ( ) ( )() ( ) ( ) 144
MDC14 DRG370 (CESAREAN SECTION WITH CC) DRG371 (CESAREAN SECTION WITHOUT CC) ( ) ( )() ( ) DRG 1. 24 2. ( ) 3. 4. 5. 6. 7. ( ) ( ) ( )() ( ) ( ) 145
DRG372 (VAGINAL DELIVERY WITH COMPLICATING DIAGNOSES) DRG37301 (VAGINAL DELIVERY WITHOUT COMPLICATING DIAGNOSES WITH CC) DRG37302 (VAGINAL DELIVERY WITHOUT COMPLICATING DIAGNOSES WITHOUT CC) ( ) 1.20 2. 3. ( ) D&C biopsy ( ) DRG 1.24 2. 3. 4. 5.Foley 6. 146
(99/7/1) BP SBP<=80 mmhg SBP>=220 mmhg 220>SBP180 mmhg PR RR BT BT>=41 BT<=32 40>BT>39 35>BT>32 >39 renal:colic BSA18-40 surgical airway BSA>40 147
148
Karnofsky Scale 0 1 2 50 3 50 4 149
Barthel Score 10 5 0 15 10 5 0 5 0 10 5 0 5 0 15 10 5 0 10 5 0 10 5 0 10 5 0 10 5 0 50 50 50 0 20 40 60 100 150
ID 1. 2. 3. 151
12 152
PCI Percutaneous Coronary Intervention (97/5/1)(99/7/1) (Chronic coronary artery disease) 1. A.(6 Mets)(99/7/1) B.(stress tests)-201 C. (VT)(VF) (Cardiac arrest) D. 5070 70 E. 2. A. a. b. 5070 70 c. 5070 70 (99/7/1) B. a.50 7070 b. 153
5070 70 c. 154
(Acute myocardial infarction, Acute MI) A.(Primary PCI for Acute MI)(99/7/1) a. b. c. (99/7/1) d. B. a. b. 50 7070 c. d. e.(infarct-related vessel) A. B. 1. 2.24 3.(stress testing) a. b. 201 c. d. 155
e. C.PCI ab c d PCI (99/7/1) 156
EPO 八 十 八 年 元 月 五 日 訂 定 流 水 號 第 一 次 洗 腎 姓 名 出 生 年 月 日 透 析 日 期 透 析 日 期 及 注 射 紀 錄 EPO 總 檢 驗 年 月 日 身 分 證 編 號 年 齡 EPO 劑 量 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 量 次 數 1 2 3 4 5 1 年 月 日 日 期 日 期 劑 量 2 年 月 日 日 期 日 期 劑 量 3 年 月 日 日 期 日 期 劑 量 4 年 月 日 日 期 日 期 劑 量 5 年 月 日 日 期 日 期 劑 量 6 年 月 日 日 期 日 期 劑 量 7 年 月 日 日 期 日 期 劑 量 8 年 月 日 日 期 日 期 劑 量 9 年 月 日 日 期 日 期 劑 量 10 年 月 日 日 期 日 期 劑 量 1.CAPD EPO CAPD 2. 3. 4.EPO (/) 157 合 計 Hct Hct Hct Hct Hct Hct Hct Hct Hct Hct 總 金 額 NT$ 元 整 BUN 或 Ccr 值 備 註
5. 6. 158
1. Ccr 5ml/min Cr 8mg/dl 2. Ccr 15ml/min Cr 6mg/dl () () (BUN>100mg/dl)BUN mg/dl () BUN Cr K Na Hct Co2 159
( ) (18 ) VIATAL SING <3M 3M-3Y >3Y-18Y <3M 3M-3Y >3Y-18Y BP PR 100 200 80 180 60 150 110 180 100 150 RR 60 20 50 20 40 15 50 RR 60 40 RR 50 30 RR 40 BT( ) 39 35 39 35 39 35 38.5 38.5 38.5 38.5 160
1. 2. 3. 4. 5. 6. ( ) 7. 8. 9. 10. 11.(>38.5 ) 12.>10 13.1500 14. 20mg/dl 15. 16. 17.() 18. 19. 1. 2. 3. 4. 5.( ) 6. 7. 8. 9. 10. >1500 11. 15mg/dl 12. 13. 161
Hemi-pelvis 162
() ID () 1. ( ) 25001C 25002C 25003C 25004C 25024C 25025C 54012C 96004C 96010C 96017C 96020C 1. 2. 3. ( ) 163
() ID () 1. 2. ( ) 3. 25001C 25002C 25003C 25004C 25024C 25025C 96004C 96020C 1. 2. 3. 4. ( ) 164
PTS2 PTS3 PTS4 PTS6 PTS7 PTS8 PTS9 PTS10 PTS12 PTM2 PTM3 PTM4 165
() 166
PTS1 10-15 10 15-30 20 PTS2 5-10 7 15-30 20 PTS3 5-15 10 15-30 20 PTS4 5-15 10 20-30 20 PTS5 5-15 10 10-15 10 PTS6 5-15 10 20-30 20 PTS7 5-15 10 20-30 20 PTS8 10-15 10 15-30 20 PTS9 10-15 10 20-30 20 PTS10 10-15 10 20-30 20 PTS11 5-15 10 5-15 10 PTS12 10-20 10 10-20 10 PTS13 10-15 10 30-40 30 PTS14 10-15 10 20-30 20 PTM1 20-30 20 20-30 20 PTM2 20-30 20 30-50 30 PTM3 20-30 20 30-50 30 PTM4 30-45 40 40-90 40 PTM5 15-30 20 15-30 20 PTM6 15-30 20 15-30 20 PTM7 10-30 20 15-30 20 PTM8 20-40 20 20-40 20 PTM9 15-30 20 15-30 20 PTM10 15-30 20 15-30 20 PTM11 10-20 10 10-20 10 PTM12 15-30 15 -- -- 167
PTM13 15-30 20 -- -- PTC1 20-30 20 -- -- PTC2 20-30 20 -- -- PTC3 20-30 20 -- -- PTC4 20-30 20 20-30 20 PTC5 20-30 20 -- -- PTC6 20-30 20 -- -- 42016C 20-45 30 -- -- PTC1-PTC6 168
( ) cerebrovascular accidents (CVA) 1. 2. ( ) cervical syndrome ( ) low back syndrome ( ) spinal cord injury 1. 2. ( ) amputation 1.BK BE 2.AK AE ( )frozen shoulder ( ) facial palsy ( ) arthritis ( ) fractures ( ) other orthopaedic disease () sprain & strain 1. 2. 3. () cerebral palsy () head injury 1. 2. () poliomylits ()Peripheral nerves injury 1.(peroneal ulnar median radial) 2. () other neurological disease () total hip & knee () chest rehabilitation 1. pre & post chest operation 2. COPD () others 6 12 3 3 6 12 2 3 6 3 3 6 1 1.5-3 1.5-3 1 6 12 3 6-9 3 3 3 169
1 2 (ROM_G) 3 (MUSCLE_G) 4 (SEN_G) 5 (MOTOR_G) 1A 1B 2A 2B ( 1.(0-20 ) 2. (21-40 ) 3.(41-70 ) 4. 2C (71-90 )) 3A 3B 3C 3D 3E 3F 4A 4B 5A 6 (AERO_G) 6A 6B 170
7 (Device) 1 2 7A 3 24 8 (SPEC_G) 1A 2A () 2C(joint play) 3A 3C 3E 4A 5A 6A 6C 6E 1B 2B 3B 3D 3F 4B 6B 6D 6F 7A (P89 P155) 171
172 (Muscle flexibility) / / (Joint mobilization technique) / / // ( )
1.E.K.G. 1. ( 2.X-ray ) 2. () ( ) ( ) () ( ) () 3. 3. 4. ( ) () ( ) (ASA) 4.( ) 5. 96004C 6. 96005C 7.( 96007C ) 96011C ( i.v.regional) 8. 96013C 9. 96017C 10. 96020C 11. 12. 173
ASA 1 2 3 4 5 6 PRE-OP DX ANES METHOD SEX HT DATE OR( ) <<<<>>>> AGE WT. PREVIOUS ANES HX Y/N NPO Y/N ANESTHESIOLOGIST RESIDENT PRE-OP CONDITION A.B O AB RH +/- SURGEON ANESTHETIC NURSE AGENTS PROCEDURE INTUBATION S. # C.X.A.B.F. L. cm N.O.D.T. PREMEDICATION FLUID N2O O2 INDUCTION EBL URINE SpO2 ETCO2 TIME BP HR BT ANESX 40 38 36 200 34 MONITOR ECG NIBP SpO2 ETCO2 TEMP TOTAL INTAKE A-LINE CVP PA Cath EEG TEE CRYSTALLOID cc TV/RR COLLOID cc PEAK AWY WHOLE BLOOD u CVP PACK RBC u PLATELET u PH FFP u PO2 PCO2 BE Na/K Ca TOTAL OUTPUT Hct SUGAR COMMAND BLOOD LOSS cc URINE cc NG cc OTHER 32 IN-/ 150 Exiube 30 ^/v OP 100 BP / mmhg HR 50 SPONT ASSIT /min CONTL REMARK POSITION 174
ICD-9-CM () 01 466 485 465 Acute Bronchitis Bronchopneumonia, Organism Unspecified Acute Upper Respiratory Infection 10000(Seg>80 or Ban>5 ) 20,000 6,000 3 1,000/mm 70,000/mm 493 Astahma 70 70 Torr 40 Torr 30 491 Chronic Bronchitis 02 592 Renal Satone Ureter Stone (include stone street after ESWL) (PaO2<60)>30 /min a. 0.5cm b. 0.5cm 175
ICD-9-CM () 03 531 Gastric Ulcer 532 Duodenal Ulcer 533 535 Peptic Ulcer Gastritis and Duodenitis a. b. c. 04 571 Liver Cirrhosis Hepatitis SGPT>300 Bilirubin >3 05 386 Vertiginous syndromes and other Disease of Vestibular system 06 583 Nephritis and Nephropathy 07 595 597 599.0 08 401 402 09 850 854 873 U.T.I Cystitis Urethritis Essential Hypertension Hypertensive Heart Disease Concussion Intracranial Injury Other Open Wound of Head (Hypertensive crisis) 2 Glasgow Coma Scale 65 6 176
ICD-9-CM () 10 922 Contusion of Trunk 891 Open Wound of knee, Leg (except Thigh) and Ankle 10 5 Rhabd omyolysis 10 2 Avulsion FlapTendon Rupture Hemoarthrosis 65 5 177
(100/11/1)() 84 9 19 84016569 85 2 16 85001960 86 1 4 86000060 87 4 15 87007495 89 6 9 89015284 91 12 20 0910023538 93 4 7 0930068296 94 2 25 0940068620 95 1 9 0940069098 95 7 7 0950068550 95 11 10 0950068682 96 3 12 0960062072 96 7 5 0960062187 96 8 6 0960062211 97 4 1 0970012154 97 4 16 0970012203 98 2 12 0980032057 98 6 18 0980095034 98 12 14 0980095828 99 2 25 0990074102 99 5 31 0990051357 99 12 6 0990082225 100 3 29 1000075057 100 10 03 1000075850 * ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 178
( ) 1 8 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) () 179
() () () () () () ( ) cephalothin, cefazolin, cephradine, cephaloridine, cephapirin ( ) cephamycin cefamandole, cefonicid, cefuroxime,cefotiam ( ) Cephamycin cefoxitin, cefmetazole ( ) Pseudomonas cefotaxime, ceftizoxime, ceftriazone, cefmenoxime ( ) Aminoglycoside tobramycin netilmicin 180
( ) Fluoroquinolone norfloxacin, ofloxacin, enoxacin, ciprofloxacin ( ) Glycopeptide vancomycin teicoplanin ( ) β-lactamase inhibitor Augmentin Unasyn ( ) ( ) (99/7/1) ( ) () (97/5/1) 1., 2. (1)( ) ( ) (2) 181
(3) (4), 3. 4. (95/7/15) 182
(98/3/1) 1. 2. (95/12/1) (99/1/1) (99/4/1) Screen 23610C 54018C 08030C 4 mmhg, 1. 1 2 2. 6mg/dl 3. 6mg/dl 4. 6mg/dl 10 mg/dl 1 2 3 183
-HCG 1. () - 2. 12022C 3. 4. ( ) 1. 19017C 2. 184
(100/5/1) 22001C 86203 C 27001C 09112C 97017C 1. 2. 3. ( ) 1. 2. B 3. ( 4. B 1. T3 toxicosis 2. T3 toxicosis 1. 2. 1. 2. -HCG 185
( ) 1. 2. 97/6/1 (1) 10.2 Penicillins & 10.3 Cephalosporins (100/1/1) (2) (100/1/1) (3) (100/1/1) 3. 4. (1)( ) (2) (3) 186
(4) (5) (6) (7) (8) 48004C 48006C 48022C 48024C 48033C 48035C (97/5/1) (9) (10) (11) Balance Salt Solution Physiologic Irrigating Solution (12)64141C (13) 187
(14) (15)(97/5/1) (16) ( ) (97/5/1) ( ) 1. IV Push 57111C 2. 3.19005B 4. (100/1/1) 5. 6. 7. 188
8. (97/5/1) 9. 10. 11. tocolytics β-mimetics 12. 13. (1)(vial) (2)(ampoule) 14. (54019C 54027C 54037C 54038C) (97/5/1) ( ) () 189
1. 2. ( ) 3. 4. 5. 6. 7. 8. IV Push ( ) 1. 2. 20% blood gas ( ) 190
( )1. (1) (100/1/1) (2) X (100/1/1) (3) (100/1/1) 2. 3. ( ) 1. (1) (2) ( ) 2. (1) KARNOFSKY SCALE() ( ) BARTHEL S SCORE()60 ( ) A 191
B C (2) (3) 3. (1) ( ) ( ) (2) ( ) 192
1. 2. 3. 4. 5. 6. 7. 8. ( ) (99/7/1) ( ) 1. IgE 20 (100/1/1) 2. ()(30021C) 30022C 3. 60 80 ( )( ID ) ()() (97/5/1) () COXⅡ NSAID antacid () (IDF) 2002 WHO 193
() ()1.( ) 2. TG( ) fibrate () Sono 30% 194
( ) 1. 2. 3. 4. 5. 6. MRI CT ( ) 7. 8. ( ) 9. (100/1/1) 10. sulfonylureas glimepiride meglitinides 195
repaglinide nateglinide(97/5/1) 11.TZD thiazolidinedione (97/5/1) (1)(IGT) (2) (3) (4) 3 6 HbA1c metformin metformin TZD 12. GPT:46 B C (97/5/1) (1)B B (2) B C (3) (4 B C 6 19009C 19009C (99/4/1)(100/1/1) 13. (97/5/1) (1) 6 1 (2) (3) urine 1 196
14.(99/4/1) (1) (2) 15.(100/1/1) ( ) 1. 2. IV Push 3. 4.19005B 5. 6. 7.GOT GPT HBSAG Anti HCV Anti HBS 8. CCr 10 ml/min UF<2.0 CCr (97/5/1) 197
Ccr 24 Cr measured Ccrestimated Ccr CG-GFR Cockcroft-Gault = 140-Age Bwt / 72 Cr 1.73/ BSA 0.85 if female MDRD-Simplify-GFR=186 Scr 1.154 Age 0.203 0.742 if female 1 Cr 6.0 CCr 5ml/min Ccr 24 CG MDRD UF<2.0 40 5 (2) BMI data residual renal function CCR Albumin 9.BC 1 ALT ( bilirubin >2mg/dL, PT prolong>3 sec) BC HBV DNA HCV RNA 2 B 6 12 HBV DNA 198
3 C ( RVR) 6 HCV RNA 4 6 (99/7/1) ( ) () 1. 2. ( ) 3. 4. 5. 6. 7. 8. IV Push 9. 37005B 199
10. 39019B ( ) 1. 2. 20% blood gas ( ) 1.EPO ( ) 2. (1) Kt/V (2) Kt/V 1.7 50 /1.73 (100/5/1) 200
3. (97/5/1) 4. 5. (1)18005B() 18006B( ) 18007B( ) (2)18007B 18006B (3)18007B 6. 2 (single lumen) 47015B( ) (double lumen) 69006C( ) 7. UGI series 8. CPR 201
9. 10. (97/5/1) 11. EPO ( ) 12.58007C(CAVH) (1) (2) (3) severe volume overloading 13. 14-1. (96/4/1) 14-2. (96/4/1) 14-3. -- 19009C (96/4/1) 14-4. B C 3 -- 19009C (96/4/1) 15. 1 202
(97/5/1) 16. Port-A 48010C 17. (WBC 1,500 50,000) 08011C 18. (96/4/1) (1) 1 (2) 1 ( ) (3) 19. (96/4/1) (1) (2) (/ (69006C) (47059B 47061B)): CCr 15 ml/min (Cr) 6.0 mg/dl A., B., C., D. 203
, E., F., G., H. (cachexia), I. (BUN > 100 mg/dl) A. 69032C B.69034C C. 47059B 47061B A. (A) CCr 15 ml/min (B) (Cr) 6 mg/dl (C) B. (AV graft) (A) CCr 12.5 ml/min (B) (Cr) 7 mg/dl (C) C. 204
(AV graft) (A) CCr 10 ml/min (B) (Cr) 8 mg/dl (C) D. 30 (Cr) 6 mg/dl 4 (Cr) 5 mg/dl (3). 58012B A. CCr 15 ml/min B. (Cr) 6 mg/dl C. A. CCr 10 ml/min B. (Cr) 8 mg/dl C. 30 (Cr) 6 mg/dl 4 (Cr) 5 mg/dl ( ) (IDF) 2002 WHO ( )1. IgE 20 205
(100/1/1) 2. ()(30021C) 30022C 3. 60 80 ( )1. (99/4/1) 2. TG( ) fibrate ( ) Sono 30% ( )1.fatty liver GPT 1-2, fatty liver 2.Sono () () ()1. 2. IGE(12031C) 08010C (Eosinophil count)()(30021c) (30022C) 206
( ) ( ) 1. 2. (99/4/1) 3.(97/5/1) (1)() (2) 25 1 2 1 2 48001C 3 48013C 6 (99/4/1) (3) 25 0.5%TBSA(Total body surface area) 48014C 48018C 4 5 48013C 4. 5. (99/4/1) 207
6. ( ) ( ) ( ) ( ) balance salt solution physiologic irrigating solution ( )( ) ( ) (Split thickness skin graft) ( ) ( ) 1. ( ) (1) -- 69014B 69015B (2) -- 69019B (3)(1) (2)-- 69019B 1+69014B 1/2-- 208
2. ( ) 69014B 69015B 3.( ) ( ) 69016B 69017B ( ) 69032B() () () 48024C ( ) () 1. 62010C () (62009C) 10CM 75602C() 2. 64087C( ) ()(clean wound) (open drainage) (infected wound) () () 209
() ()(49004C) 49004C 48013C () 83048C () 1. 2.Danzen Varidase () ( ) ( )(51020C) ( )(64116B) (62010C) (62010C) (64116B) ( ) (48001C) (56006C) ( ) ( )(18008B) 210
1.(PAOD) 2. (IABP) 3.(ECMO) 4. ( )RH(D) (11003C) 1. Rh0(D) 2. ( )(29017C) (95/12/1) (29017C) 211
( ) (78607C 4550 ) ( ) tendon repair ( )(64208C) ( )1.clean wound 2 2. unclean wound ( ) 48027P 48028P ( ) (97/5/1) ( )(97/5/1) ( )Danzen Varidase (97/5/1) 212
( ) (97/5/1) ( ) 48033C 48034C 48035C (97/5/1) ( )(74417C) : (97/5/1) 1. 2. 3. 1 2 2 3 3 4. ( ) (97/5/1) 213
( ) 1. 2. (99/4/1) 3. 10.2 Penicillins & 10.3 Cephalosporins (97/5/1)(100/1/1) 4. 5.( ) 6. 7.(97/6/1) (1) (2) (3) (100/1/1) (4) 1 214
2 3 ( ) (100/1/1) 8. (99/4/1) 9. 48011C( ) 10.() 11. 14 (100/1/1) 12. Nebulizer (99/4/1) 13. O2 tent O2 hood (57014B) 14. 1 2 (100/1/1) 215
ACEI ARB Aldosterone X X X X X X X X X ( ) 1. 2.( ) ( ) 1. 2. ( ) 1. ( ) 2. 216
3. (1) (2) (3) 4. (57009B) (1)AMBU bag 57009B (2)IMV Resuitator( ) IMV 57009B( ) 5.Postural drainage(47045c) Postural drainage(47045c) special sheet ( ) COX NSAID ( )1. COXⅡ NSAID antacid antacid 2. NSAID antacid ( )1. IgE 20 (100/1/1) 2. ()(30021C) 30022C 3. 60 80 217
( )( ID ) ( )1. 2. TG( ) fibrate ( ) Sono 30% ()1.fatty liver GPT 1-2, fatty liver 2.Sono ()1. 2. specific allergen test IgE(12031C) 08010C (Eosinophil count)()(30021c) (30022C) (99/4/1)(100/1/1) ()2 Menthol Packing (97/5/1) 218
( ) 1. 2. 3. 4. 5. 55010C ( ) 1. 2. 3. 4. 5. 96004C 6. 219
7. ( ) 1. 2. (99/4/1) 3. (97/5/1) 4. 5. 6. (tocolytics) ()( ) 7.Clomiphene citrate (101/2/1) ( ) 80403B80412B 80413B 1.80403B 220
2.80412B (parametrium) 3. 80413B 80414B 70208B 70209B ( ) 4. (80402B) stage biopsy 81014B ( ) 80014C ( ) 1. (1) (2) (3) (4) (5) 2. 221
( ) ( ) ( ) ( ) ( ) 1.13006C 2.16007C () 1. 2. (80403B) (80404B) 3. () 222
1.Fetal distress( ) 2.Failure to progress in active labor() 3.APH(placenta previa, abruptio placenta)() 4.Malpresentation (including twin with malpresentation)( ) 5.Cord prolapse() 6.Induction failure( ) 7.Active genital herpes() 8.Previous C/S( ) 9.Previous uterine surgery() 10.Vulvar and/or vaginal condyloma acuminata, diffuse( ) 11.Treatable fetal anomalies(e.g. gastroschisis, omphalocele, hydrocephaly)( ) 12.Preeclampsia with() (1)uncorrectable severe preeclampsia (2)HELLP syndrome with failed induction (6hrs) (3)eclampsia with poor induction progress (6hrs) 13.Extremly premature fetus < 1500gm( NICU ) ( <1500 ) 14.Pelvic deformity (sequela of poliomyelitis or traffic 223
accident, etc.)() 15.Fetal macrosomia (>4000gm EBW)(>4000 ) 16.Cephalopelvic disproportion (CPD)( ) 17.Obsructive labor (e.g. myoma, ovarian tumor) ( ) 18.Major medical complications( ) 19. HIV(+)(98/8/1) 20. (98/8/1) () MTX () (101/2/1) () () (101/2/1) () () (28014C) () (18013C 18014C) 18035B 224
() () () urine acetone ( )Folliculometry ( ) ( ) IUD IUD displacement ( ) PAP smear () ( )C/S (ATH,VTH ) 1.C/S (ATH,VTH ) 2.(ATH,VTH ) ( ) (99/4/1) ( ) (97/5/1) 1. 2. 225
3. ( ) 1. (D&C) 2. (D&C) 3. ( ) ( ) ( ) ( ) Pulse or ear Oximetry (57017B) (47031C) ( ) 1. (1)17 (2)17 29 (3)29 2. 3.(99/4/1) ( )1.(97/5/1) 2. (100/1/1) 226
( )( NST ) (97/5/1) ( ) 55015C(97/5/1) 227
( ) (64245C 64246B 64247C) kpin ( ) ( )()( ) ( ) 1. multiple fracture (2 components )2. open fracture 3. pediatric fracture 4. complications neuro vascular injury visceral organ injury infections etc 5. joint fracture or joint dislocation (101/2/1) 6. special condition femoral neck fracture ( ) CRP ESR (97/5/1) ( ) ( ) (100/1/1) ( ) X 228
X X X X (95/12/1) (100/1/1) ( ) X () () X (95/12/1)(100/1/1) ( ) X X (95/12/1) ( (100/1/1) 229
( )(79404B 79405B 79406B 79411B 79412B 97401K 97402A 97403B) 1. (97/5/1) 2. BPH 3. 4. 78026C 5. 5 79407C (97/5/1) ( ) 1. 2. (79407C) ( ) 1. ( ) U.V.J.stone ( )(78026C) 2. 230
3. (ESWL) (1) A.KUB Sono B.IVU 3.RP (2)ESWL ESWL (3) () (4) ( ) Eviprostate Nephronorm (101/2/1) ( ) PGE1 60mcg ( )(99/4/1) ( ) Video-urodynamic study (21006B) (21004C)(21007C)(21003C) 231
( ) (50010C) ( ) (05221A) (50011C) (37005B) 05221A ( )50020C (97/5/1) 1. (paraphimosis) 2. 3. 4. 5. ()BPH bethanechol (97/5/1) 1.BPH bethanechol finasteride -blocker 3 2. on Foley detrusor 3. DM 1 4.DM AUR 232
5.NB neurogenic bladder urinary retention on Foley 233
( ) ( ) 54023C ( )(57007C) (57021C) ( ) ( ) (101/2/1) ( ) ( ) - (54019C)- (54027C) (54037C) (54038C) (99/4/1) (100/1/1) ( ) SMT UPPV 234
(101/2/1) () ( ) (97/5/1) 1. 65072B 65074C 1 Wound treatment and change dressing 54027C 5 5 (99/4/1) 2. 65074C 3.()(65003C) ( ) ( )1.(VFT) Nann Romberg VFT 2. 3. ()1. 2. IGE(12031C) 08010C 235
(Eosinophil count)()(30021c) (30022C) ()1. IgE 20 (100/1/1) 2. ()(30021C) 30022C 3. 60 80 () 14 (97/5/1)(100/1/1) () ( ) (97/5/1) 236
( ) ( ) ( ) 1. ( ) 2. 5mm ( ) 3. 4. 5. (99/7/1) 6.(100/1/1) ( ) 1. 2. ( ) 1. (101/2/1) () 2. 237
(101/2/1) 3. 4.(23401C) DBR (A )(23503C)(23001C) 5. 6. 86008C 86009C 86010A 7. 86012C 86012C 86013C 8. carbamycholine acetylcholine chloride 1% 9.(101/2/1) () 10. (97/5/1)(100/1/1) 11.(101/2/1) () 12. (101/2/1) 13. 238
14. 85205C K-reading 53010C (97/5/1) 15. 16. 86006C 86007C 86008C 86011C 86012C 86013C ( ) 1.() 2. 3. ( ) 4. 5.(23702C) 239
(PRP) 23702C( ) 6.( FAG Fluorescein Angioraphy) 7. (1) 86207B 1 /2 85608B ( ) (2) 85608B 1 /2 86206B ( ) (3)85608B( ) (4) 86404B (5) 86403B ( )86206B 86207B 1.86206B 2.86207B ( ) 1. (85213B) ( 240
)(85213B) 1 /2 ( )(86008C) 2. ( )1. (101/2/1) 2. (23201C) (23202C) (23203C)(23204C) (23205C) (23206C)(23207C) (23208C) ( )(60001C 60014C) 1.60003C 60004C X2() 60003C 60004C 2.60005C 60006C 60005C 60006C 3.60007C 60008C X1 60007C 60008C (101/2/1) 4.60011C 60012C YAG 60011C 5.60013C 241
6. 7.(60001C) (60002C)(60003C) (60004C) () (60005C) () (60006C) 8. ( ) () 1. ( ) 2. 3. 4. 5. 6. ()23706C (23401C) () 23803C 1.(23702C) (23501C) 2. 242
3. 4. () 53024C 9 (97/5/1) () 2.0D 23001C (97/5/1) ()1. 2 2. (97/5/1) () (97/5/1)(99/7/1) ()23305C (97/5/1)(99/7/1) () (85201C) 1. 2. () 53016C 243
( ) (99/7/1) ( ) ( ) ( ) (99/7/1) 53010C 85205C K-reading (97/5/1) 87004C 87005C 87017C (100/1/1) 244
( )(51017C) 51021C 51022C (95/12/1) 1.(99/7/1) (1)51017C 3 ( ) 2 2cm 2 (shaving) (2)51021C 1 2 1cm (3)51022C 2 2 1 2 1cm 2cm 2 (4) 51017C (99/7/1) (101/2/1) ( ) 51009C 51011C 1. 2. ( ) 1. (1)51005C 245
(2)51006C 2. ( ) 51020C (abscess) 51004C ( ) ( ) () ( ) ( ) tranexamic acid ( ) Sporanox (itraconazole) Lamisil(tenbinafine) azole allylamine (97/5/1)(100/1/1) ( ) ()Acne therapy 51004C ( ) ()Tazorac Silkis (101/2/1) () ()Elidel Protopic Oint 246
() 2 () (101/2/1) () () 62001C 62010C 51003C () (95/12/1) (101/2/1) ()(30022C) IGE(12031C) (08010C ) (30022C) (95/12/1) () (95/12/1) () Antihistamine() 2 (97/5/1) acyclovir (99/7/1) 247
( ) 1. 2. 3. 4. ( ) 1. 2. CT MRI 3.() 4. 248
5. 20013B() 20021B( ) (101/2/1) (1) (TIA) (2) (3) 6. 20026B() ( TIA) (101/2/1) ( ) NCV, F-wave, H-reflex EEG 1. (1) (2) (3) (4) (5) 2.H-reflex (1) (2) (3) spasticity 249
3.F-waves (1) (2) (3) (4) 4.EEG EEG (1) (2) 250
(99/7/1) (3) Alzheimer disease R/O Jakob-Creutzfeldt disease Jakob-Creutzfeldt disease R/O Alzheimer disease 5. ( ) 1. 2. blood gas 251
252
( ) coma scale T.P.R ( ) CT MRI brain concussion ( ) Pulse Oximeter ( )() (57017B 57018B) Arterial Blood Gas ( )Perineal care Foley care indication routine ( ) Specific gravity ICU care D.I. order ( ) ( )Diprivan ( ) 1.Delayed ICH () CT scan recurrentich complication 2.Spinal stenosis Laminectomy()() (83003C)() Diskectomy(83022C) (83023C)(83024C) Diskectomy 253
1 Laminectomy(83002C 83003C) 1/2 3.Open depressed fracture+ich ICH depressed fracture CT Scan 4.Transsphenoidal surgery SMR 1/2(65004C) Bone Graft 64002B 62009C 254
( ) ( ) (45040C 45041B 45042C) ( ) ( ) 1. 2. (1) (2) ( ) 255
(3) (4) ( ) (95/7/15) 1.( )(45094C) 1 (100/1/1) 2 3 2.supportive individual psychotherapy 45010C (99/6/1) 3. re-educative individual psychotherapy 45087C 45088C 45089C 1 2(99/7/1) 3 (99/7/1) 256
4. 40 intensive individual psychotherapy 45013C 45090C 45091C 1 2 3 A. B. (99/7/1) C. D. 40 5. supportive group psychotherapy 45016C (99/7/1) 6. intensive group psychotherapy 45019C 1 2 3 4 90 257
2. 3. 4. 5. (99/7/1) ( )1. 2. (45037A 45038B 45039C) ( ) (45034A,45035B,45036C) ( ) (45079C 45080B 45081C) 258
( ) ( )(45046C 45098C 45099C) (95/7/15) ()(45055C 45056B 45057C) () (95/7/15) 259
( ) ( ) (97/5/1) 1. () 2. ( ) ( )(100/1/1) ( )( ) ( ) ( ) 41005C ( ) 41006B 260
( ) 51018B 51019B ( ) 47039C -- ( )43010C 43023C ( ) ( ) () (97/5/1) () (myofascialpain) 1. ( ) 39018C() 2.. (Trigger Point Inj).( ). (), () 261
() (101/2/1) () () ( ) ( ) () 42016C 42016C ()(101/2/1) () X (95/12/1) ()X X (95/12/1) ( ) X X (95/12/1) ( ) 262
( ) (97/5/1) ( ) (97/5/1)(99/7/1) X- (100/1/1) 263
( ) 1. 2. ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( PTCD ) ( ) ( ) 36011B 36012B 264
( )(25001C 25003C) ( SNOMED coding number) ( SNOMED coding number ) ( SNOMEND coding number ) ( ) ( ) ( ) 25001C 265
( ) () (Pulse Oximeter)(57017B) ( ) ( ) ( ) ( ) ( ) (96025B)(96026B) ( )96003C ( ) (IV IM anesthesia)(96004c) ( )96004C short induction barbiturates thiopental methohexital Etomidate Ketamine Propofol 266
( ) () () 96011C 267
BP SBP<=80mmHg SBP>=220mmHg 220>SBP180mmHg PR RR BT BT>=41 BT<=32 40>BT>39 35>BT>32 >39 renal:colic BSA18-40 surgical airway BSA>40 268
Karnofsky Scale 0 1 2 50 3 50 4 269
Barthel s Score 10 5 0 15 10 5 0 5 0 10 5 0 5 0 15 10 5 50 50 50 0 10 5 0 10 5 0 10 5 0 10 5 0 0 20 40 60 100 270
ID 1. 2. 3. 271
12 272
EPO EPO EPO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1 2 3 4 5 1 2 3 4 5 6 7 8 9 10 1.CAPD EPO CAPD 2. 3. 4.EPO (/) 5. 6. Hct Hct Hct Hct Hct Hct Hct Hct Hct Hct NT$ BUN Ccr 273
1. Ccr 5ml/min Cr 8mg/dl 2. Ccr 15ml/min Cr 6mg/dl () () (BUN>100mg/dl)BUN mg/dl () BUN Cr K Na Hct Co2 274
( ) (18 ) VIATALSING <3M 3M-3Y >3Y-18Y <3M 3M-3Y >3Y-18Y BP PR 100 200 80 180 60 150 110 180 100 150 RR 60 20 50 20 40 15 50 RR 60 40 RR 50 30 RR 40 BT( ) 39 35 39 35 39 35 38.5 38.5 38.5 38.5 1. 2. 3. 4. 5. 6. ( ) 7. 8. 9. 10. 11.(>38.5 ) 12.>10 13.1500 14. 20mg/dl 15. 16. 17.() 18. 19. 1. 2. 3. 4. 5.( ) 6. 7. 8. 9. 10. >1500 11. 15mg/dl 12. 13. 275
Hemi-pelvis 276
() ID () ( ) 1. 25001C 25002C 25003C 54012C 96004C 96010C 96017C 96020C 1. 2. 3. ( ) 277
() ID () 1. 2. ( ) 3. 25001C 25002C 25003C 25004C 96004C 96020C 1. 2. 3. 4. ( ) 278
PTS2 PTS3 PTS4 PTS6 PTS7 PTS8 PTS9 PTS10 PTS12 PTM2 PTM3 PTM4 279
() 280
PTS1 10-15 10 15-30 20 PTS2 5-10 7 15-30 20 PTS3 5-15 10 15-30 20 PTS4 5-15 10 20-30 20 PTS5 5-15 10 10-15 10 PTS6 5-15 10 20-30 20 PTS7 5-15 10 20-30 20 PTS8 10-15 10 15-30 20 PTS9 10-15 10 20-30 20 PTS10 10-15 10 20-30 20 PTS11 5-15 10 5-15 10 PTS12 10-20 10 10-20 10 PTS13 10-15 10 30-40 30 PTS14 10-15 10 20-30 20 PTM1 20-30 20 20-30 20 PTM2 20-30 20 30-50 30 PTM3 20-30 20 30-50 30 PTM4 30-45 40 40-90 40 PTM5 15-30 20 15-30 20 PTM6 15-30 20 15-30 20 PTM7 10-30 20 15-30 20 PTM8 20-40 20 20-40 20 PTM9 15-30 20 15-30 20 PTM10 15-30 20 15-30 20 PTM11 10-20 10 10-20 10 PTM12 15-30 15 -- -- 281
PTM13 15-30 20 -- -- PTC1 20-30 20 -- -- PTC2 20-30 20 -- -- PTC3 20-30 20 -- -- PTC4 20-30 20 20-30 20 PTC5 20-30 20 -- -- PTC6 20-30 20 -- -- 42016C 20-45 30 -- -- PTC1-PTC6 282
( ) cerebrovascular accidents (CVA) 1. 2. ( ) cervical syndrome ( ) low back syndrome ( ) spinal cord injury 1. 2. ( ) amputation 1.BK BE 2.AK AE ( )frozen shoulder ( ) facial palsy ( ) arthritis ( ) fractures ( ) other orthopaedic disease () sprain & strain 1. 2. 3. () cerebral palsy () head injury 1. 2. () poliomylits ()Peripheral nerves injury 1.(peroneal ulnar median radial) 2. () other neurological disease () total hip & knee () chest rehabilitation 1. pre & post chest operation 2. COPD () others 6 12 3 3 6 12 2 3 6 3 3 6 1 1.5-3 1.5-3 1 6 12 3 6-9 3 3 3 283
1 1A 1B 2 (ROM_G) ( 1.(0-20 ) 2. (21-40 ) 3.(41-70 ) 4. (71-90 )) 2A 2B 2C 3 (MUSCLE_G) 3A 3B 3C 3D 3E 3F 4 (SEN_G) 4A 4B 5 (MOTOR_G) 5A 284
6 (AERO_G) 6A 6B 7 (Device) 1 2 7A 3 24 8 (SPEC_G) 1A 2A () 1B 2B 2C(joint play) 3A 3C 3E 4A 3B 3D 3F 4B 5A 6A 6B 285
6C 6E 6D 6F 7A (P89 P155) 286
287 (Muscle flexibility) / / (Joint mobilization technique) / / // ( )
1.E.K.G. 1. ( 2.X-ray ) 2. () ( ) ( ) () ( ) () 3. 3. 4. ( ) () ( ) (ASA) 4.( ) 5. 96004C 6. 96005C 7.( 96007C ) 96011C ( i.v.regional) 8. 96013C 9. 96017C 10. 96020C 11. 12. 288
ASA 1 2 3 4 5 6 PRE-OP DX ANES METHOD SEX HT DATE OR( ) <<<<>>>> AGE WT. PREVIOUS ANES HX Y/N NPO Y/N ANESTHESIOLOGIST RESIDENT PRE-OP CONDITION A.B O AB RH +/- SURGEON ANESTHETIC NURSE AGENTS PROCEDURE INTUBATION S. # C.X.A.B.F. L. cm N.O.D.T. PREMEDICATION FLUID N2O O2 INDUCTION EBL URINE SpO2 ETCO2 TIME BP 40 HR 38 BT 36 200 ANESX 34 MONITOR ECG NIBP SpO2 ETCO2 TEMP TOTAL INTAKE A-LINE CVP PA Cath EEG TEE CRYSTALLOID COLLOID WHOLE BLOOD u CVP PACK RBC u PLATELET u PH FFP u PO2 PCO2 BE Na/K Ca TOTAL OUTPUT Hct SUGAR COMMAND BLOOD LOSS cc URINE cc NG cc OTHER 32 IN-/ 150 Exiube 30 ^/v OP 100 BP / mmhg HR 50 SPONT ASSIT /min CONTL REMARK POSITION cc TV/RR cc PEAK AWY 289
ICD-9-CM () 01 466 485 465 Acute Bronchitis Bronchopneumonia, Organism Unspecified Acute Upper Respiratory Infection 10000(Seg>80 or Ban>5 ) 20,000 6,000 3 1,000/mm 70,000/mm 493 Astahma 70 70 Torr 40 Torr 30 491 Chronic Bronchitis 02 592 Renal Satone Ureter Stone (include stone street after ESWL) (PaO2<60)>30 /min a. 0.5cm b. 0.5cm 290
ICD-9-CM 03 531 532 533 535 () Gastric Ulcer Duodenal Ulcer Peptic Ulcer Gastritis and Duodenitis a. b. c. 04 571 Liver Cirrhosis Hepatitis 05 386 Vertiginous syndromes and other Disease of Vestibular system 06 583 Nephritis and Nephropathy 07 595 597 599.0 08 401 402 09 850 854 873 U.T.I Cystitis Urethritis Essential Hypertension Hypertensive Heart Disease Concussion Intracranial Injury Other Open Wound of Head SGPT>300 Bilirubin >3 (Hypertensive crisis) 2 Glasgow Coma Scale 65 6 291
ICD-9-CM ( ) 10 922 Contusion of Trunk 10 5 Rhabd omyolysis 891 10 Open Wound of knee, Leg (except Thigh) and 2 Ankle Avulsion Flap Tendon Rupture Hemoarthrosis 65 5 292
(97/5/1) A. GOT GPT B. GOT GPT 2 HBV or HCV C. GOT GPT 2 HBV or HCV D. E. 1 2 1 2 293
(IDF) 2002 WHO Type 2 Diabetes Practical Targets and Treatments The Overweight or Obese Person With Diabetes TABLE 2 Management algorithm for overweight and obese type 2 diabetes mellitus. Failure Add biguanide, TZD or -glucosidase inhibitor Failure Combine two of these or add sulphonylurea Or glinide Failure Add insulin OR change to insulin Check Adherence at Each step TZD=thiazolidinedione If control is poor, oral agents may be started early In certain a situations, insulin may be required (see text for details) 294
Obese/Non-Obese Guidelines for Combination therapy When commencing Insulin Source The Malaysian Consensus, 1996 (currently under revision) Continue oral hypoglycemic agents Intermediate-acting/long-acting insulin after 10 pm Initial dose 0.2 units/kg Adjust insulin by 2-4 units after a minimum of 3 days+ Aim for FPG 4-8 mmol/l(individualise) - Proceed to twice dally insulin if control is inadequate The Non-Obese Person With Diabetes TABLE 3 Management algorithm for normal weight type 2 diabetes mellitus Diet exercise and weight control* Failure Add sulphonylurea, biguanide, -glucosidase inhibitor Or glinide Failure Combine sulphonylurea or glinide with biguanide And/or -giucosidase inhibitor and/or add TZD Failure Add insulin OR change to insulin TZD=thiazolidinedione If control is poor, oral agents may be started early Use of TZD may be appropriate earlier in patients with features of metabolic syndrome In certain situations, insulin may be required (see text for details) 295
Guidelines for Combination therapy When commencing Insulin Source The Malaysian Consensus, 1996 (currently under revision) Continue oral hypoglycemic agents Intermediate-acting/long-acting insulin after 10 pm Initial dose 0.2 units/kg Monitor FPG Adjust insulin by 2-4 units after a minimum of 3 days+ Aim for FPG 4-8 mmol/l(individualise) Targets/Special Situations Targets for Control Many of these targets are based on results from studies conducted in Europe; it is important for individual countries to use these as a basis for the formulation of guidelines targeted at their own populations. TABLE 4 Targets for control Plasma glucose (mmol/l) Optimal Fair Poor fasting 4.4-6.1 7.0 7.0 Non-fasting 4.4-8.0 10.0 10.0 HbAlc( ) 6.5 6.5-7.5 7.5 Blood pressure (mmhg) 130/80 130/80 140/90 140/90 male BMIkg/m2 25 27 27 female 24 26 26 Total cholesterol (mmol/l) 4.5 4.5 6.0 HDL-cholesterol (mmol/l) 1.1 1.1-0.9 0.9 Triglycerides (mmol/l) 1.5 2.2 2.2 296
LDL-cholesterol (calculated) 3.0 2.5-4.0 4.0 For equivalent whole blood glucose values, see note on page 10 Reference range depends on the method used. For this method, non-diabetic HbA10 6.0 calibrated to DCCT (Goldstein) As these figures relate to European populations, lipids and BMI should be within the normal range for the population in each country. Appendix V for conversion factors between conventional and Systeme International (SI) units 297
The American Journal of Medicine, V01 118 (5A),May 2005) Table 2 potential combination regiments for type 2 diabetes mellitus Sulfonylureas Secretagogues Metformin Glitazones Glucosidase inhibitors Sulfonylureas XXXXXXXX?Benefit Secretagogues?Benefit XXXXXXXX?Increase in hypoglycemia Metformin XXXXXXXX?Increased GI Side Effects Glitazones XXXXXXXX Glucosidase inhibitors?increase in Hypoglycemia?Increased GI Side Effects XXXXXXXX Summary Just as other fields (e.g, hypertension, infectious disease) changed ranged dramatically with the availability of combination medications, the treatment of type 2 DM has been radically altered by the relative rapid release into the clinical arena of drugs with distinct mechanisms of actions. Initial studies demonstrating benefit over placebo have been followed by studies demonstrating additive benefit to monotherapy. The next level of investigation, which has only recently begun, focuses on evaluating different 2-drug combination regimens (Table 2). Although many combinations have been examined in some fashion, other agents cannot be combined because of overlapping therapeutic actions or side effects. For instance, a study combining a longer-acting sulfonylurea and a shorter-acting secretagogue is unlikely to be undertaken given the similar mechanisms of action. Similarly, the potential for severe postprandial hypoglycemia would seem too high to prompt a study of a short-acting secretagegue and a glucosidase inhibitor. Lastly, the combination of metformin and acarbose would likely cause excessive GI side effects And be tolerable. From a clinical perspective, these studies suggest relatively similar benefits in glucose control for any particular 2-combination regimen. Of great interest, the recent studies involving TZDs raise the strong possibility that combination regimens many have advantages with regard to nonglycemic risk factors. However, beyond the beneficial effects on risk factors, it is the 298
adverse effect of a particular regimen that may end up determining which combination regimen is chosen for a specific patient. Individual concerns over hypoglycemia, GI side, or edema may tip the scale away from one permutation and toward another. Most of the recent studies have spanned<2 years, and nearly all have evaluated surrogate markers of diabetes-related complications without having reported on concrete clinical outcomes. The impact on markers and risk factors appears quite promising. However, longer-term clinical trials are needed to confirm the clinical benefit of combination therapy, Until head-to-head comparisons are available, clinicians will the challenge of comparing different studies conducted by different investigators with different patients in different settings. As combination studies proceed, appropriate control groups using alternative combination regimens should be included to ensure that optimal regimens are identified. Additional comparisons to insulin therapy (with or without oral agents) will likely be needed to help configure a cost/benefit approach. Potential problems associated with combination therapy (e.g monetary costs, side effects) should be identified and openly discussed. As these questions are answered, subsequent studies evaluating >2 agents will likely be undertaken to determine an optimal approach to the treatment of type 2 DM. 299
(99/4/1) 300
無 心 血 ( 管 如 疾 附 病 註 患 一 者 ) 給 有 予 下 三 列 物 至 情 治 六 況 療 個 之 月 一 非 時 藥, 應 (99/7/1) 2 TC/HDL-C>5 () HDL-C<40mg/dl 200mg/dl <200mg/dl ( 240mg/dl <240mg/dl ) LDL-C 130mg/dl <130mg/dl 160mg/dl <160mg/dl TG 200mg/dl <200mg/dl(87/4/1) ( TC/HDL-C>5 HDL-C<40mg/dl) 病 有 患 或 心 者 糖 血 尿 管 病 疾 藥 同 物 時 治 予 療 以 非 TC 200mg/dl <160mg/dl(87/7/1) LDL-C 130mg/dl 100mg/dl(87/7/1) TG 200mg/dl( <150mg/dl(87/7/1) TC/HDL-C>5 HDL-C<40mg/dl) 500mg/dl ( ) ( ) ( ) ( ) () () ( ) ( ) () (TIA) 70% ( ) 1. 2. 3. 45 4. 5. 55 6.() 302
(97/5/1) 9.0mg/dl 7.0mg/dl 5 mg/dl 5 mg/dl 302
(100/11/1)() 84 9 19 84016569 85 2 16 85001960 86 1 4 86000060 87 4 15 87007495 89 6 9 89015284 91 12 20 0910023538 93 9 10 0930068680 93 10 8 0930019269 95 1 9 0940069098 95 7 7 0950068550 95 11 10 0950068682 96 3 12 0960062072 97 4 1 0970012154 97 7 18 0970012454 98 2 12 0980032057 98 6 18 0980095034 98 12 14 0980095828 99 2 25 0990074102 99 5 31 0990051357 99 12 6 0990082225 100 3 29 1000075057 100 10 03 1000075850 (101/2/1) * (99/4/1)(100/11/1)() (99/4/1)(100/5/1) Amalgam Filling AF or AMF Lower Right LR Buccal B Mesial M Block Anesthesia B.ANES Myofascial Pain Dysfunction Syndrome MPDS 303
Camphorated Monochloro CMCP Normal Saline N.S. Phenol Camphorated CPC Occlusal O Parachlorophenol Cervical C Occlusal Adjustment Occ.adj Composite Resin Filling CRF Operative Dentistry OD Distal D Oral Hygiene Instruction OHI Endodontic Treatment ENDO Tx Oral Surgery O.S. Extraction EXT Palatal P Facial Buccal F&B Periodontal Perio Formalin Cresol FC Rubber Dam RD Full Mouth FM Residual Root/Retained Root R.R. Glass Ionomer Cement GIF Root Canal Enlargement RCE Filling Gutta Percha GP Root Canal Filling RCF Gutta-Percha Point G-P POINT Root Canal Treatment RCT Incisal edge I Temporo-Mandibular Joint TMJ Incision & Drainage I&D TMJ and Muscle disorder TMD Labial /Facial F Upper Anterior UA Lingual L Upper Left UL Local Anesthesia L.ANES Upper Bilateral UB Lower Anterior LA Upper Right UR Lower Left LL Working Length WL Lower Bilateral LB (100/11/1)() 304
(100/11/1) (100/11/1)() (100/11/1)( ) 68 (100/11/1)() (100/5/1) X X X X X X X 305
(99/4/1)(100/1/1)(100/5/1) (101/2/1) 3 5 (99/4/1) (101/2/1) ( ) ( )() ( ) ( ) ( ) () ( ) (98/3/1) (100/11/1)() 91001C 90004C 92001C 306
(100/11/1)() ( ) ( ) ( ) (99/4/1) (100/11/1) () () (98/3/1) () (98/3/1) () ( ) ( ) (98/3/1) () (99/1/1) (100/11/1)() 307
X (101/2/1) () 01271C 01273C (99/4/1) ( ) 8 01271C 01272C 01273C ( )( ) X (99/7/1) (101/2/1) ( ) 1. 2. 3. ( ) ( ) (101/2/1) ( ) (O.D.) ( (101/2/1) ( ) ( ) (101/2/1) 308
( ) O.D. (89006C) (101/2/1)() ( ) (101/2/1) ( )ENDO 90001C 90003C 90019C 90020C mm ISO instruments ADA ISO RCF (97/5/1) 97/9/1 (100/5/1) () (101/2/1) ( ) 5mm ( ) 2mm (99/4/1) ( ) : ( ) 309
(101/2/1) () X 90018C 90016C 3mm (99/4/1) (101/2/1) () 90007C 1 (99/4/1) () (90015C) clamp (90012C)(90012C) (99/4/1) (101/2/1) () ()Gutta percha points filling X 2 Gutta percha points overfilling ( ) 310
Over filling (Over filling GP over filling (98/3/1) (101/2/1) () (91006C-91008C) (91009B-91010B) (98/3/1) () () (91011C- 91012C) ( ) 91003C 91004C X X (99/4/1) (101/2/1) () 91001C (100/5/1) (101/2/1) 311
( ) 92001C 92066C 92066C 92001C (99/4/1)(100/5/1) () 92002C 92001C 92007B 92008B 92006C (99/4/1) () (92003C-92004C) () () (92005C) 92014C (97/5/1) (101/2/1) () () 92015C 92016C () (92041C)(91011C) 92041C 91011C ()CO2 312
TMJ (98/3/1) () 92067B (99/4/1) () X (99/1/1) 313
(100/11/1)() 84 9 19 84016569 85 2 16 85001960 86 1 4 86000060 87 4 15 87007495 89 6 9 89015284 91 12 20 0910023538 93 9 1 0930068663 94 9 16 0940068938 95 1 9 0940069098 95 7 7 0950068550 95 11 10 0950068682 97 4 1 0970012154 98 2 12 0980032057 98 9 3 0980095409 98 12 14 0980095828 99 12 6 0990082225 100 10 03 1000075850 * M.P ( ) 314
( ) 98/10/1 (100/11/1)() ( ) (97/5/1) ( ) (100/11/1)() (100/11/1)( ) 315
(95/7/15) (100/11/1)() (100/1/1) (100/11/1)() (97/5/1) 1. 2. 3. 4. B61 2-6 B62B63 ( B54B53 ) 316
26 (95/7/15) (98/3/1) ( ) ( )(95/12/1) (99/1/1) (99/1/1) (100/11/1)() 317