• Title/Summary/Keyword: 초기진료

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The proposal about the effective management of outside data (외부 병원 Data의 효율적 관리에 대한 제언)

  • Lee, Hwa-Sun;Lee, Rae-Gon;Kang, Ji-Yeon;Hwang, Sun-Kwang
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.31-35
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    • 2007
  • 외부 데이터가 진료병원 Server에 저장됨에 있어서 판독을 의뢰하지 않을 경우, 대부분의 병원이 무상으로 이루어 지고 있는 상황이며 이에 외부 데이터 단순 import의 효율적인 관리를 위한 수가 적용 여부를 검토하였다. 2007년 3월부터 4월까지 서울 경기 지역의 PACS가 도입 된지 1년 이상, 병상 수 500Bed 이상의 종합 대학병원 25곳에 근무하는 각 병원의 PACS 운영실 및 PACS 관리자를 대상으로 하였다. 외부 데이터에 관한 10가지 항목의 설문지를 작성하여 각 병원의 PASC 담당자 및 관리자를 대상으로 E-mail을 이용한 자기 기입 방식, 전화를 통한 질의응답 방식으로 조사하였다. 조사된 25개의 종합 대학병원의 96%이상이 외부 데이터 단순 import를 지원하고 있었으며, 그 중 92%의 병원은 무상으로 이루어지고 있었다. 이와 같이 진행 되는 부분에 대하여 각 병원의 PACS 담당자 70% 이상이 단순 import에 대한 수가 적용의 필요성을 느끼고 있으며, 현재 많은 병원에서 단순 import의 무상 지원으로 인한 문제점을 인식하고 있었다. K병원을 기준으로 단순 import에 년간 H/W 소요 비용은 336만원이고, 년간 인건비 소요비용은 421만원이다. 또한 단순 import 한 건당 평균 데이터 size는 48MB 정도로 조사되었다. 환자 입장에서 진료에 참고자료로 사용 될 외부 데이터의 정확한 저장과 정당한 PACS 사용을 위해서는 그에 상응하는 수가가 적용 되어야 할 것이다. 보험심사평가원 급여기준에 따라 수가적용이 인정되어 의료영상 디지털화로 인한 초기의 고액 투자비용 보장과 회수를 위해 단순 Import의 수가 적용이 반드시 필요하다고 사료 된다.

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Importance of integrating Bioinformation and Health Informatics for Healthcare

  • 곽연식
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2002.06a
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    • pp.89-104
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    • 2002
  • 유전체연구사업단은 국내에서 발병 및 사망빈도가 가장 높은 위암과 간암의 퇴치를 목적으로 국가적 특목전략사업으로 연구를 추진하고 있다. 이와 별도로 보건복지부에서는 22개의 중요 질병별 유전체 연구센터를 전국적으로 추진하고 있다. 따라서, 연구가 성공적으로 진행되면 각 연구소에서 독자적으로 개발하여 제공하는 생명정보의 양은 거의 무한에 이를 것이다. 그러나 생명정보는 환자진료에 도움을 주기 위해서는 궁극적으로 임상정보와 함께 유기적으로 통합되어야 한다. 임상정보와의 통합을 위해서는 의료기관의 진료정보와 연구소의 생명정보가 연계되어 엄밀한 임상실험이 추가적으로 실시되어야 한다. 뿐만 아니라 생명정보학의 발전을 위해서는 연구대상의 임상정보가 공유되어야 한다. 유전체정보를 이용하는 생명정보학(Bioinformatics)은 각 국가마다 전략사업으로 간주하여 막대한 투자가 이루어지는 새로운 분야이다. 현재 선진국에서 개발 사용 중인 시스템의 연간 사용료가 고가이므로 국내 도입은 거의 불가능하거나 또는 매우 비효율적이다. 유전체 또는 생명정보의 임상활용 및 생명정보연구를 위한 임상정보 공유를 위해서는 우선 다음의 사항이 개발되어야 한다. 1) 다음과 같은 개별환자의 정보를 각 의료기관에서 제공 받아 저장 활용한다. - 진찰 및 임상소견, 수술기록, 경과기록, 검사결과 (임상병리, 해부병리, 방사선 등), - 영상정보 (X-ray, CT, MRI, 초음파, 전자현미경, 그래픽 등), - 환자개인기록(병력, 과거력, 가족력, 알러지 등), - 예방접종 기록 2) 각 연구소에서 첨단기술을 이용하여 개발되는 생명정보를 임상에 활용하기 위해서는 유전체연구센타와 병원간에 임상정보와 유전체 분석정보의 공유가 필수적으로 발생하게 됨으로, 유전체 정보와 임상정보의 통합은 미래 의료환경에 필수기능이 될 것이다. 3) 각 생명공학 연구소에서 사용하는 첨단 분석 장비와 생명공학 정보시스템의 자동 연계가 필요하다. 현재 국내에는 전국적인 초고속정보망이 가동되어 웹을 기반으로 하는 생명정보의 공유는 기술적으로 문제가 될 수 없으나 임상정보의 유전체연구에 그리고 유전체연구정보의 임상활용은 다양한 문제를 내포하고 있다. 이에 영상을 포함한 환자정보의 유전체연구센터와 병원정보시스템과의 효율적인 연계통합 운영을 위해 국내에서는 초기 도입단계에 있는 국제적인 보건의료정보의 표준인 Health Level 7 (textural information 공유), DICOM (image 및 wave 공유), 관련 ISO표준, WHO의 ICD9/10 (질병분류), LOINC (검사 및 관련용어), SNOMED International (의학용어) 등을 활용하여야 한다.

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A Study on Community Mapping for ICT-Based Livestock Infectious Disease Response (ICT 기반 가축 감염병 대응을 위한 커뮤니티 매핑 연구)

  • Koo, Jee Hee;Pyeon, Mu Wook
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.3
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    • pp.247-257
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    • 2020
  • Livestock epidemics, such as foot and mouth disease, are causing enormous economic losses due to their strong infectious power. Early detection of infectious diseases in livestock is very important, but it is difficult to diagnose early in individual farms, and there are frequent cases of transmission through inter-farm movement such as veterinarians and feeding vehicles. In this study, we studied the technology that enables rapid diagnosis without veterinarian farm visits and prevents further spread by automatically monitoring the body temperature of livestock using ubiquitous-based information and communication technology in the early stage of onset and sending it in real time. We have presented a technique for systematically managing livestock epidemics at the farm level, regional level, and national level by using the community mapping technique by using the remote medical treatment system linked to the automatically collected information. In this process, community mapping items for each step and stakeholders were derived for crowd sourcing based spatial information technology.

Guideline for the Management of Neonates Born to Mothers With COVID-19 (코로나19 감염 산모에서 출생한 신생아 관리 지침)

  • Jae Hong Choi ;Soo-Han Choi ;Do-Hyun Kim ;Yong-Sung Choi ;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.125-130
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    • 2022
  • For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference.

Change in Perception on Dental Fear for Health and Non-Health Sciences University Students after Oral Health Education (보건학과와 비보건학과 대학생들의 치과공포도와 구강보건 교육 후 치과공포 인식변화)

  • Nam, Seoul-Hee;Kim, Min-Jin;Kim, Seo-Hui;Byun, Hyo-Eun;Baek, Seung-Hun;Lee, Hae-Rim;Jeong, Eun-Seol;Hong, So-Yeon;Jeong, Mi-Ae
    • The Journal of the Korea Contents Association
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    • v.17 no.10
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    • pp.102-109
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    • 2017
  • This study is to seek a method to alleviate fear of dental treatment among college students. Research objects are students in public health department and those in other departments on. B University located in area A from April 5, 2017 to April 12, 2017. They were provided with education, and given two surveys before and after the education. The survey data were analyzed with the SPSS 19.0 program using T-test. The findings of the analysis are as follows. After the education, fear of dental treatment was reduced more among students in the public Health Department than among those in other departments. After education on dental treatment, there were greater changes in oral health among students in non-public health departments than those in the Public Health Department. There were grater changes in oral health among students in the Public Health Department than those in other departments. It is necessary to cultivate dental technicians through efficient and professional education, and those dental technicians should serve to reduce fear of dental care among the people, and change consciousness on such treatments. Accordingly, it is necessary to develop efficient education programs to reduce fear and increase the consciousness of dental health among people, and make people not afraid of coming to dental clinic.

Initial Symptoms of Malignant Bone Tumors (악성 골 종양의 초기 증상)

  • Oh, Joo-Han;Lee, Sang-Hoon;Suh, Sung-Wook;Lee, Ho-Kyoo;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.18-23
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    • 2003
  • Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.

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A Study of Psychiatric Impotance on the Openning of Nae-ui-won(內醫院)

  • Lyu Yong-Su;Lyu Hui-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.2 no.1
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    • pp.19-28
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    • 1991
  • 내의원(內醫院)은 병원과 약국을 겸비한 일종의 궁중의료기관으로 의사를 비롯하여 여러의원들이 임금과 왕비 및 왕자들의 약을 조제하여 달이던 곳으로, 일명 내국(內局) 또는 약원(藥院)이라고 내의원 앞에 예시되어 있다. 그러나 내의원은 현재 그 내용이 전해지지 않고, 단지 관광지의 유물로만 여겨지고 있다. 현재의 내의원은 창덕궁(昌德宮)에 위치하고 있다. 내의원은 창덕궁의 돈화문(敦化門)을 지나, 인정전(仁政殿)을 거쳐 희정당(熙政當) 좌측에 있으며, 왕비의 거처인 대조전에 가장 가까이 자리잡고 있다. 내의원은 조선왕조 세종25년(1443)에 개원하게 되었으니, 이때는 정치, 문화적으로 안정이 이루어져 가는 상황이었다. 또한 당시 왕이나 왕비 기타 왕족들의 여러 가지 정신적인 갈등으로 인한 질병이 많았으며, 이로인해 전문적이고 독립적인 왕실의료기관의 필요성에 의해 내의원이 독립적인 개원이 이루어졌으리라 사료된다. 이로인하여 저자가 내의원에 관한 자료조사와 실제답사를 통하여 다음과 같은 사실을 알수 있었다. 1) 내의원의 개원은 조선왕조 초기 중앙의료질서 성립을 통한 봉건왕조의 절대왕권확립을 의미함으로 사료된다. 2) 내의원의 위치가 창덕궁의 중심부에 위치하고, 특히 어전(御殿)과 내전(內殿) 가까이에 위치함은 왕실의 질병을 신속하고도 중요하게 다루기 위함으로 사료된다. 3) 특히 의인을 내전에서도 대조전(大造殿) 가까히 둔것은 왕실의 질병중 왕비의 정신신체질환의 치료를 위함으로 사료된다. 4) 내의원의 진료형태는 왕진(往診)이었으며, 이는 당시 의원신분이 중인층이었음으로 사료된다. 5) 내의원의 이용중에서 평민에게는 왕명에 의해서만 이루어졌음으로 사료된다.

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Left Ventricular Hypertrophy and Prelude to Hypertensive Cardiovascular Diseases: from the Pediatric Cardiologist's Point of View (좌심실 비대와 고혈압성 심혈관 합병증: 소아 심장 의사의 관점)

  • Cho, Min-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.14-21
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    • 2011
  • Although left Left ventricular hypertrophy (LVH) is not only an adaptive response of the heart to increased cardiac workload in hypertension, it surelybut also is the most potent risk factor of overt cardiovascular complications such as coronary heart disease, heart failure, arrhythmia and stroke in the hypertensive population. Also it has become generally accepted that subclinical cardiovascular disease begins in childhood and LVH is the most readily assessed marker for that. As LVH can be seen in children and adolescents with even mild blood pressure elevation with the reported prevalence of 10 to 47%, aggressive antihypertensive treatment is critical in preventing the development of hypertensive heart disease in that those cases.

An IT/Medical Converged Solution based on the Expert System for Enhancing U-Healthcare Services in Middle-sized Medical Environment (중소형 의료 환경에서 U-헬스케어 서비스 향상을 위한 전문가 시스템 기반 IT/의료 융합 솔루션)

  • Ryu, Dong-Woo;Kang, Kyung-Jin;Cho, Min-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1318-1324
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    • 2010
  • Recently, U-Healthcare is receiving attentions as a research for reducing the manpower, time in treatment, and etc. Although fundamental technologies, such as sensing, measuring, and etc. are sufficiently investigated. However, Technologies of IT/Medical convergence, which graft IT technologies to medical area, are still in germ. For this, we present a novel healthcare system, which can be applied to the middle sized medical environment, such as private hospital, home, or etc., by means of pre-verified technologies and the expert system. There exist IT element technologies are sufficiently developed in the fields, such as network, database or etc. due to the remarkable developments in IT technologies, and the healthcare is a mission-critical environment. Therefore, it is important not only to investigate novel approaches but also to utilize verified technologies for the U-Healthcare solution. Presented solution provisions automated medical services based on expert system by utilizing the measured data, such as body fat, blood pressure, blood glucose, and etc., in order to provide convenient treatment environment to doctors and nurses. In addition, since people, who do not have medical knowledge, can self-diagnose themselves, it is expected to cut medical costs in various areas. Especially, since each devices communicate with each other through standardized Bluetooth technology, Presented healthcare system is an extensible solution which can easily accept various medical devices. As a result of this, we can safely say that the self measurement and diagnosis services in U-Healthcare are now enhanced by reducing medical cost through our healthcare system.

Analysis of the Trend and the Factors Influencing the Usage Before and After the Application of the National Health Insurance for the Magnetic Resonance Imaging (자기공명영상의 건강보험 적용 전·후 이용량 동향 및 요인 분석)

  • Gil, Jong-Won;Choi, Sung-Oog
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.477-484
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    • 2016
  • This study was carried out to determine the factors affecting the trend and usage of Magnetic Resonance Imaging before and after the implementation of National Health Insurance. The research materials were the MRI Execution Data, Health Insurance Review Data, and Medical Expenses in the Health Insurance Data from a General Hospital located in Dae-jeon Metropolitan City from 2004 to 2013. The subjects of analysis were 3,754 people in 2004 (prior to the implementation of Health Insurance), and 4,107-8,603 people from 2005-2013(after the implementation of Health Insurance). In terms of analysis, a comparison of the use of MRI before and after implementation of the Health Insurance of User Characteristics and Provider Characteristics were taken as $X^2$, while factor analysis for the elements that affect MRI usage was carried out by Hierarchical Multiple Regression Analysis. According to the results of this study, the level of use decreased temporarily in the initial application stages of the national health insurance, but it soon increased. In particular, the inspection rates for women, the head and neck, those not subject to the application of the national health insurance, internal medicine, and the inpatients increased. The application of the national health insurance for MRI influenced the increasing inspection rates (P<.0001). As the inspection rate for the MRI increased, it is important to expand the application of the national health insurance to reduce the national health expenditure.