• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.18 no.11
• /
• pp.2691-2696
• /
• 2014

SNOMED CT is a standard clinical terminology to provide a standardized way to record and manage clinical records for EMR or EHR. The structure of SNOMED CT is very complex because of huge expressive power and its internal design mechanism. Although there are some SNOMED CT browsers for browsing and searching SNOMED CT concepts, they are less effective because they do not consider such complexity of SNOMED CT. This paper depicts problems of current SNOMED CT browsers and analyze SNOMED CT dataset. Then, this paper analyze requirements of SNOMED CT browser which improves searching and selecting of appropriate clinical terms.

• Korean Medical Education Review
• /
• v.8 no.1
• /
• pp.55-59
• /
• 2006

현대 의학의 발달과 더불어 최근 의학교육에는 많은 변화가 일어나고 있다. 그 중에서 최근 주목 받기 시작한 분야가 의학 시뮬레이션(medical simulation)이다. 시뮬레이션은 과거 강의 위주의 교육에서 한걸음 더 나아가 학생으로 하여금 임상에 가까운 상황에 접하게 함으로써 임상 진료 및 위기 상황을 경험하게 하여 지식과 수행을 통합하는 교육 방법이라고 할 수 있다. 또한 다양한 임상 경험을 할 수 있으며 환자에게 위해가 가해질 가능성이 없고, 학생에게도 안전한 교육 방법으로써 세계 여러 국가들이 도입한 교육 방법이다. 물론 시뮬레이션 교육은 비용과 시설 및 인력 요건의 구비가 상당히 많이 필요한 것이 사실이다. 그럼에도 불구하고 세계의 많은 대학들이 시뮬레이션에 투자하는 것은 의학교육의 흐름에 중요한 영향을 주고 있기 때문일 것이다. 최근 한국의 의학교육에서도 새로운 교육과정의 도입과 의사국가고시 실기시험이 도입되는 등 급격한 변화의 바람이 불면서 의학시뮬레이션 센터를 구축하는 곳이 늘어나고 있다. 의학 시뮬레이션의 세계적 동향을 주목할 필요가 있으며 시뮬레이션은 의료인의 자질 함양은 물론 환자들의 신뢰를 얻는 데에도 커다란 영향을 미칠 것이다.

• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.75-103
• /
• 2017

There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
• /
• 2014.10a
• /
• pp.416-417
• /
• 2014

SNOMED CT is a standard clinical terminology to provide a standardized way for recording and managing of clinical records in EMR systems. However, because of its huge expressive power, it is very difficult to consistently record patients' status such as diagnosis and procedure. The reason is that one clinical meaning can be expressed in variety of ways using multiple terminologies and vice versa. This paper proposes a novel requirement of effective search browser for SNOMED CT terminologies by analyzing duplicated or similar terminologies.

• The Journal of the Korea Contents Association
• /
• v.8 no.11
• /
• pp.242-250
• /
• 2008

Patients with atopic dermatitis, an intractable disease, suffer uncontrollable psychological distress as well as various symptoms in their skin. Recent findings showed that mental factors such as stress may play a role in the disease and that some techniques for alleviating psychological problems were efficacious in the atopic dermatitis. Therefore, we proposed the mind-body medicine that has been used to decrease the negative influences of stress and to cure psychosomatic disorders as an additional remedy for the atopic dermatitis. A model on the therapeutic effect of mind-body medicine and some qualities of practician also were discussed.

• The Korean Society of Law and Medicine
• /
• v.13 no.2
• /
• pp.11-38
• /
• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• The Journal of the Korea Contents Association
• /
• v.10 no.10
• /
• pp.304-317
• /
• 2010

The purpose of this study is to research on attitudes toward legalization of death with dignity. The respondents are 561 adults aged 20 years old and over, living in Seoul and Kyunggi Province. Research questionnaire consist of 28 questions concerning general background, personal experiences of death, attitudes toward death, pros and cons on death with dignity and legalization. Statistical analyses employ frequency, mean, cross tab, and t-test. 87.3% of respondents agree the legalization of death with dignity. The persons who are older, self-employed, and production employees, get married, live with spouse, believe buddhism, experience care for the death, believe life after death, recognize the necessity of testament agree more on death with dignity. The first requisite for legalization of death with dignity is the standard of judgement concerning self decision on death with dignity. The decision makers are prioritized by self, family member in order. The necessary services for decisions on death with dignity are the mediation role between medical team and family, medical information about illness prognosis and prolongation, psychological counselling on depression.

• The Korean Society of Law and Medicine
• /
• v.17 no.1
• /
• pp.3-43
• /
• 2016

The North Korean medical laws are consisted of 'People's Health Act' and 'Medical Act' in the peak of the North Korean constitutional law. Before the legislation of 'People's Health Act', a number of medical laws and regulations existed. But, at present, there is no information about its amendment and effectiveness. 'People's Health Act' legislated in 1980 declared fundamental principles and policies of the North Korean health care system. 'Medical Act' legislated in 1997 is the basic law among the North Korean medical laws. It presented the goals and fundamental principles of the North Korean health care, and then regulated the basics about 'Tests and Diagnosis', 'Medical Treatment', and 'Medical Appraisal'. 'Medical Act' of North Korea was established later than South Korea, and its provisions is smaller in number. And there are lots of abstract and declaratory provisions compare with South Korean 'Medical Act'. Especially there is no provision about the kind and requirements of medical personnel and medical institutions, so it is hard to grasp the North Korean health care system at once. Regarding the medical treatment, there are many similar contents between the North and South Korean 'Medical Act'. But, the provisions, such as regarding mixing the new medicine and the korean traditional medicine, encouraging natural therapies in medical treatment, and informing the patient's protector of bad diagnostic result if there is concern to have a bad influence on patient, are different from the South Korean 'Medical Act'.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.2
• /
• pp.164-167
• /
• 2021

Down syndrome is the most common chromosomal disorder and is accompanied by hip osteoarthritis in approximately 28% of patients. This paper reports a case of hip arthrodesis as a treatment for severe hip osteoarthritis in adolescent Down syndrome patients. When performing surgical treatment of patients with Down syndrome, it is necessary to take a comprehensive approach that considers not only the medical point of view, but also the psychological and economic requirements of the patient and their social environment.

• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.105-138
• /
• 2017

This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.