• Quality Improvement in Health Care
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• v.15 no.1
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• pp.89-100
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• 2009

문제: 소화기병검사실에서 대장내시경 검사의 부도건수가 최근 월 200명 정도로 예약인원의 16%에 달한다. 이는 본원 외래진료 부도율이 평균 10%인 것과 비교할 때 상당히 높은 결과이므로 대장내시경 예약환자를 대상으로 부도율 관리를 위한 활동이 필요하였다. 목적: 외래 및 입원환자의 부도건수 및 부도환자의 특성을 분석하고, 개선활동을 통하여 대장내시경 검사의 부도율을 줄인다. 의료기관: 서울 아산병원. 질 향상 활동: 부도관리를 위한 개선활동으로 SMS 횟수를 2주전, 4일전, 1일전 3회로 변경하고, 내용도 각 시기마다 차별화하였다. 대장내시경 검사 예약을 하고 기다리는 환자를 대상으로 처방일 순, 예약 날짜순서 등 필요한 항목 순으로 볼 수 있는 리스트가 필요하여 예약대기 프로그램을 개발하였고, 처방일로부터 2주 이내 자동예약을 금지하였다.(7월 10일부터 시작) 예약대기명단에 있는 환자를 대상으로 전화로 예약 변경을 하여 2주 이내에는 예약의 빈자리가 없도록 하였다. 미리 부도를 예측하여 추가로 예약하던 방법에서 정원조정을 하여 정원 외 추가 예약을 하지 않았다. 입원환자 일정관리를 위하여 일정관리 프로그램을 개발하여 타과의뢰 회신을 하는 전임의가 직접 날짜를 전산에 입력하여 회신과 동시에 검사실, 담당주치의, 담당 간호사가 모두 일정을 확인할 수 있도록 하였으나 프로그램이 늦어져 9월 12일부터 시행하였다. 개선효과: 부도건수가 개선 전 8주 동안 385건(예약인원 대비 16%) 에서 개선 후 6주의 평가기간 동안 256건(예약인원대비 14.1%)으로 129건이 감소하였으며, 검사 1-2일전 일정 변경 연락 환자 감소 및 검사 비용 수납 환자의 부도건수가 감소하였다. 대장내시경 검사 예약대기 프로그램 운영 및 예약 변경 전화 활동으로 2달씩 기다리던 환자의 예약일을 약 한 달 정도 단축하여 줄 수 있었다. 검사 정원 관리의 결과로 검사 예약 시 예약기준이 명확해지고, 부적절한 예약으로 인한 검사지연 등이 확실히 줄었다. 또한 입원환자 일정관리 프로그램 적용으로 입원환자의 검사일정과 관련된 전화업무는 확실히 줄어들 것으로 예상된다.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.169-208
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• 2016

"Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

• Journal of dental hygiene science
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• v.8 no.4
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• pp.261-266
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• 2008

The purpose of this study was to examine the effects of the toothpick method, one of professional toothbrushing methods, on the prevention of periodontal diseases and the satisfaction level of patients with that. The subjects in this study were 33 patients who included 16 men and 17 women. After the toothpick method was applied to the selected patients from January 9 to February 28, 2008, the collected data were analyzed with SPSS (Statistical Package for the Social Science) 12.0 program. The findings of the study were as follows: First, the patients investigated showed a 0.71 reduction in PI than in the past. The index of bleeding upon probing stood at 5.12, which dropped from 8.09 in the beginning. Second, the patients gave a mean of 4.20 to the professional toothbrushing out of possible five points, which showed that they expressed satisfaction with that. Third, as for the relationship between general characteristics and satisfaction level, the women were more satisfied with that ($4.25{\pm}0.33$). By age group, those who were in their 60s and up found that more satisfactory ($4.31{\pm}0.30$). Fourth, as to changes in oral symptoms by gender, the largest number of the men and women considered their gums to become healthier after the professional toothbrushing was applied. The above-mentioned findings suggested that dental institutions should be equipped with well-educated oral health care personnels who are responsible for the periodontal health of patients, and the development of oral health promotion programs is urgently required as well.

• Journal of dental hygiene science
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• v.10 no.4
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• pp.211-218
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• 2010

The purpose of this study was to examine preference for dental hygienists. The subjects in this study were 228 employees in general hospitals located in the region of Busan, on whom a survey was conducted in May and June, 2009. The findings of the study were as follows: As for top priority of dental hygienists' duties, providing assistance for dentist treatment ranked first(28.2%), followed by scaling(23.2%) and preventive duties(20.6%). Concerning a favorable image of a dental hygienist, a cheerful look was most preferred(61.4%), followed by a clean-cut look (32.9%), a refined look (3.5%) and an intellectual look (2.2%). Among the subjects, married respondents exhibited a greater liking for a cheerful look, and the gap between them and the unmarried subjects was statistically significant($x^2=8.11$, p<.05). In terms of uniform preference, a two-piece suit with pants was most favored(76.3%). Female respondents showed a greater preference for a two-piece suit with pants, and the gap between them and the male respondents was statistically significant($x^2=41.09$, p<.001). As for major qualifications, professional knowledge was most valued (49.1%), followed by integrity/responsibility(23.2%), friendliness(22.4%), and a great personality/being well-cultivated(5.3%). Employees who were in their 40s and up placed more importance on integrity and responsibility, and the gap between them and the others was statistically significant($x^2=20.62$, p<.01).

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.31-44
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• 1997

저자들은 악관절내장증의 증상과 징후의 객관적 평가법을 개발하기 위하여 서울대학교치과 병원 구강진단과 악안면동통진료실을 내원한 환자중 좌우 양 관절중 한 관절 이상의 관절에 악관절내장이 있는 남자 8명(평균연령 19.9$\pm$2.9세), 여자 34명(평균연령:32.8$\pm$11.8세) 총 42명(84개 관절)에 대하여 VAS 및 압통역치 측정, 악관절조영술, 골신티그래피 검사 및 악관절 활액의 분석을 시행하였다. 악관절 동통의 심도는 VAS로 측정을 하였으며 PPT는 electronic algometer로 평가를 하였다. 악관절조영사진을 얻기 직전 활액을 채취하였으며 그 성분중 Hyaluronic acid, 총단백질, IgG, IgM과 albumin을 분석하여 그 상관관계를 분석한 결과 다음과 같은 결론을 얻었다. 1. 악관절 내장증으로 내원한 환자 42명, 총 84개 관절중, 무통성이고 관절잡음이 없는 경우가 7개 관절, 무통성이고 단순관절음만 존재하는 경우가 18개 관절, 동통 및 단순관절음이 존재하는 경우가 18개 관절, 간헐적인 폐구 과두걸림이 있는 경우가 11개 관절, 급성 폐구성 과두걸림의 경우가 11개 관절, 만성 폐구성 과두걸림의 경우가 3개 관절, 퇴행성 관절질환이 존재하는 경우가 16개 관절이었다. 2. 연구대상중 18명의 환자, 총 36개 관절에 대한 골 신티그래피 검사 결과, 활동성으로 나타난 경우가 33개 관절이었고 이중 23개 관절이 동통성이었으며, 활동 상태 관절의 VAS 항목과 압통역치 항목 및 여러 검사 항목들은 비활동 상태 관절의 항목과 유의한 차이를 나타내지 않았다. 3. 악관절내장의 진행정도에 따른 악관절부위의 동통의 측정에 있어서는 압통역치의 측정보다는 VAS에 의한 방법이 더 유용하며 특히, 후방부의 촉진시에 유의한 정보를 얻을 수 있었다. 4. 악관절 내장즈으이 진행 단계에 따라, VAS항목과 압통역치 항목을 비교해 본 결고, 주기적인 과두걸림(II) 단계에서 가장 높은 VAS 수치와 가장 낮은 압통역치를 나타내었으며 상방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계와 증상 및 징후가 없는(0) 단계 사이와 후방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계 및 퇴행성 관절 질환(V) 단계와 증상 및 징후가 없는(0) 단계 사이에서만 유의성을 나타내었다. 5. 활액내 총단백질량, albumin 량, IgG 및 IgM 농도는 악과？ㄹ 내장증의 진행에 따라 유의성을 나타내지는 않았으나 퇴행성 관절 질환(V) 단계에서 증가되는 양상을 나타내었다. 6. 활액내 hyaluronic acid의 농도는 악관절 내장증의 진행에 따라 유의성을 나타내지는 않았으나 만성 폐구성 과두걸림(IV) 단계에서 감소되는 양상을 나타내었다.

• Korean Journal of Social Welfare
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• v.1
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• pp.1-8
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• 1979

본 연구(硏究) 보고서(報告書)는 중앙대학교(中央大學校) 부설(附設) 사회복지관(社會福祉館) 운영(運營)의 합리성(合理性)과 그 기능(機能)의 고찰(考察)을 중심(中心)으로 하여 저소득층(低所得層)에 있어서 사회복지관(社會福祉館)의 역할(役割)과 그 봉사활동(奉仕活動)의 내용(內容)이 어떠해야만 한다는 가설(假說)과 합리성(合理性)을 개최(開催)하는 동시(同時)에 금반(今般) 이스라엘, 예루살렘에서 1978년 8월 14일부터 8월 18일까지 개최(開催)하는 국제사회사업(國際社會事業) 대학협의회(大學協議會) 설립(設立) 50주년(周年) 기념학술대회(記念學術大會)에서 본(本) 연구보고서(硏究報告書)를 발표(發表)하도록 의뢰함으로써 그에 준(準)하여 작성(作成)하였으며 동시(同時)에 영문(英文)으로 기재하였다. 본 부설(附設) 사회복지관(社會福祉館)의 운영(運營)의 월지(越旨)와 목적(目的)은 아래와 같이 요약(要約)하고자 한다. 복지사회(福祉社會) 건설(建設)이라는 시대적(時代的)이며 전국적(全國的)인 여망(與望)에 부응(副應)하여 대학(大學)은 그 선도적(先導的) 역할(役割)을 담당하고 인간(人間)의 존엄성(尊嚴性)과 생존(生存)의 교리(?利)를 주장할 뿐만 아니라 국가부흥(國家復興)의 80년대(年代)를 향한 복지시책(福祉施策)의 기를 공고(鞏固)히 하고 사회사업(社會事業)의 토착화(土着化) 내지(內至) 자주성(自主性)을 확립(確立)해야 한다는 철학적(哲學的) 사명(使命)을 다하여야 하기에 본(本) 중앙대학교(中央大學校) 사회사업학과(社會事業學科)에서는 그러한 시범사업(示範事業)의 일환(一環)으로 본(本) 대학교(大學校)가 위치(位置)하고 있는 인근지역(隣近地域)에 사회복지관(社會福祉館)을 설립(設立)하고 다음의 세가지 목적(目的)을 달성하고저 광범(廣範)한 사업(事業)을 계획(計劃), 전개(展開)하고 있다. 1. 사회사업학(社會事業學)은 이론(理論)과 실제(實際)의 긴밀한 연계(連繫)가 강조되는 학문(學問)으로서 학생(學生)들의 실습(實習)을 교수(敎授)가 직접적으로 지도(指導), 감독(監督)함으로써 사회사업(社會事業)의 전문생(專門生)을 개발(開發)내지 발전(發展)시켜 나가야 한다. 2. 직접봉사(直接奉仕)와 학구적(學究的) 실험(實驗)을 통하여 새로운 봉사기술(奉仕技術)과 사업계획(事業計劃)을 개발(開發)하고 정립(定立)시킴으로써 국가적(國家的) 차원(次元)에서 실제분야(實際分野)에 직접 응용(應用)되도록 하여야 한다. 3. 대학(大學)이 위치(位置)하고 있는 인근지역(隣近地域), 특히 영세주민((零)細住民)들의 욕구(慾求)에 따라서 적절(適切)한 봉사(奉仕)를 직접 제공(提供)하여 줌으로써 지역사회문제(地域社會問題) 해결(解決) 참여(參與)하여야 한다. 4. 사업내용(事業內容) 위의 목적(目的)을 달성(達成)하기 위하여 다음과 같은 사업(事業)을 한다. (1) 청소년(靑少年) 집단지도사업(集團指導事業) (2) 가정복지사업(家庭福祉事業) (3) 아동상담사업(兒童相談事業) (4) 의료진료사업(醫療診療事業) (5) 야간교육(夜間敎育事業) (6) 독서실운영사업(讀書室運營事業) (7) 직업훈련사업(職業訓練事業) (8) 가족계획사업(家族計劃事業) (9) 법률상담사업(法律相談事業) (10) 탁아시설사업(託兒施設事業) (11) 기타(其他) 위와 관련(關聯)된 사업(事業)

• Health Policy and Management
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• v.29 no.2
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• pp.105-111
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• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.3
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• pp.312-320
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• 2019

One of the fastest growing segments of implant dentistry is the utilization of computed tomography (CT) scan data and treatment planning software in conjunction with guided surgery for implant reconstruction cases. Computer assisted planning systems and associated surgical templates have established a predictable, esthetic, functional technique for placing and restoring implants. Especially, a philosophy of restoratively driven implant placement has been generally adopted. Recently, a variety of commercial dental fields have released their scanning and fabricating protocols and methods for restorations. This process is still being investigated and developed for the most precise and predictable outcome. This case report describes a female patient who wanted dental implants in fully edentulous areas. Restoratively driven implant placements were performed with surgical guide and the patient was fully satisfied with the clinical results, and at 5-year post restorative follow-up assessment, both implant and prosthesis were proved clinical success.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.3
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• pp.1-13
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• 2020

Objectives : The objective of this survey was to examine students' perception of the clinical performance examination (CPX) in college of traditional Korean medicine using student standardized patients. Methods : College of traditional Korean medicine students who completed the first-semester clinical practice education were selected as the subjects, and they participated in a survey asking questions about the following matters: satisfaction with CPX, self-evaluation, difficulties experienced during the CPX course, level of prior knowledge of clinical practice education, and usefulness of and intimacy with Student Standardized Patients (SSP). Results : Satisfaction with CPX was calculated to be 4.10 (5 being the perfect score), and self-evaluation of CPX was calculated to be 4.12. The subjects chose physical examination as the most difficult item relating to CPX. 80.5% responded positively to the question relating to diverse experiences in practice education, and 52.8% responded positively to the question relating to prior knowledge of diverse standardized patients. 55.6% responded positively to the question relating to performance proficiency of SSP, 63.9% responded positively to the question relating to usefulness of SSP to prepare for CPX, and 69.4% responded positively to the question relating to usefulness of SSP in evaluating CPX, and 55.6% responded positively to the questions relating to intimacy with SSP. It was confirmed that there was a strong quantitative correlation between prior knowledge of clinical practice education and usefulness of SSP, and that there was a strong quantitative correlation between performance proficiency of SSP and usefulness of SSP. It was confirmed that there was a middle-level correlation between performance proficiency of SSP and intimacy with SSP, and that there was a middle-level quantitative correlation between intimacy with SSP and usefulness of SSP. Conclusions : It was confirmed that senior students enrolled in college of traditional Korean medicine were mostly satisfied with the clinical performance examination in college of traditional Korean medicine using SSP, and that usefulness of SSP had a quantitative correlation with prior knowledge of diverse clinical practice educations, performance proficiency of SSP, and intimacy with SSP.

• Korean Journal of Acupuncture
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• v.38 no.1
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• pp.16-31
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• 2021

Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.