• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.3.1-3.8
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• 2018

Background: In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of β-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge. Methods: A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient. Results: The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out. Conclusions: Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.3
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• pp.11-21
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• 2014

The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.9 no.8
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• pp.1834-1839
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• 2005

Database security is essential to protect their data in most organization such as hospitals, central or local governments, banks which manage the private, sensitive and important data. Because the duty of the department recently became more various and complicated, the changes of security requirement are needed more frequently. Therefore, easily changeable, flexible security policy and efficient security management with preserving the integrity of security policy are very important. In this paper, we implemented a flexible database security system in the specimen and clinical information management system of leukemic research center using IRH(Improved Role Hierarchy). Data is protected by MAC and we propose a flexible access control and effective administration by using the IRH that is an improved role hierarchy of RBAC. If security policy is needed for changes, this system can do it easily by simply modifying the IRH with the decentralized administration. The modified security policy can be applied flexibly after alteration because the security level of the subject is not fixed but can be derived automatically from the IRH when user connects the system.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.13-24
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• 2015

Background: Controversy persists regarding the use of coronary endarterectomy (CE) in patients with severe coronary artery disease. We compared the comorbidities and perioperative characteristics of patients undergoing coronary artery bypass grafting (CABG) with and without CE. Methods: This study was performed in two private hospitals in Shiraz, Iran from May 2010 to December 2011 on 967 patients who underwent CABG without CE and 84 patients who underwent CABG with CE (the CE+ group). After follow-up at $9.66{\pm}3.65$ months post-surgery, 28 patients from the CE+ group underwent angiography to evaluate the patency of grafts and native coronary vessels. Results: Patients in the CE+ group had a more prevalent history of diabetes (48% vs. 36%) and number of diseased vessels ($2.88{\pm}0.39$ vs. $2.70{\pm}0.85$). The overall hospital mortality was 1.8%, and no significant difference was observed between the two groups. In the 28 patients who underwent reangiography, 113 vessels were bypassed and 29 endarterectomies were performed, mostly on the left anterior descending artery (12 endarterectomies) and the right coronary artery (8 endarterectomies). In the endarterectomized vessels, a 66% patency rate was found in both the grafts and the native vessels. The native coronary vessels were more likely to be patent when the left internal mammary artery was used as a conduit than when a saphenous vein bypass graft was used. Conclusion: The lack of a significant difference in postoperative complications in patients who underwent CABG with or without CE may indicate that CE does not expose patients to a higher risk of complications. Since most of the endarterectomized vessels were shown to be patent during the follow-up period, we propose that endarterectomy is a viable option for patients with severely diseased vessels.

• The Journal of Korean Academy of Sensory Integration
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• v.16 no.2
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• pp.26-35
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• 2018

Objective : The aim of this study was to investigate job tasks of Korean pediatric occupational therapists focusing on sensory integration intervention provided in hospitals, private centers, welfare centers, and to identify job differences depending on the types of agency. Methods : A survey was performed for 122 pediatric occupational therapists focused on sensory integration intervention by utilizing a questionnaire from July to September 2017. The questionnaire was consisted of job description for the pediatric occupational therapists. Results : There were differences in tasks' importances, frequencies, and difficulties according to the three type of agency. Differences were showed total 10 tasks in importance, total 7 tasks in frequency, and total 2 tasks in difficulty depending on the agency type. Conclusion : Occupational therapists need to identify job differences depending on agency type and to develop essential competencies required to perform the job tasks which emphasized at each agency.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.360-370
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• 2022

Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

• Korean Medical Education Review
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• v.24 no.1
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• pp.10-17
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• 2022

South Korea is not a wasteland of publicly funded health care-instead, it has a good medical social security system known as the national health insurance (NHI). The NHI of Korea has three unique features; (1) low premiums, low insurance fees, and low coverage; (2) obligatory designation of medical institutions; (3) and allowance of non-benefit services. These features have made hospitals and doctors interested in profit-seeking. However, the commercialization of medical institutions has taken place in both private- and public-established sectors. A basic problem of commercialization is the co-existence of the obligatory designation of medical institutions and non-benefit services. The problem became worse in the Kim Dae-Jung government because it officially permitted non-benefit services. Since 2000, the Korean government has consistently pursued benefit extension policies, but the coverage rates of the NHI have stagnated. In addition, premiums and current medical expenses have markedly increased because policy-makers have emphasized accessibility to the NHI, while ignoring important principles of medical social security such as a needs-based approach and patient-referral system. In order to resolve the commercialization problem, the obligatory designation of medical institutions to the NHI should be changed to a contract system, and non-benefit services should be prohibited at NHI institutions. We must re-establish the patient-referral system via a needs-based approach. We also need to build a primary healthcare system and public health policies. We should make a long-term plan for healthcare reform.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.135-145
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• 2023

Purpose: This was a descriptive study investigating the effect of symptom experience and self-care agency on quality of life among patients with stage 5 chronic kidney disease undergoing regular hemodialysis. Methods: The participants were recruited from one general hospital and two private hospitals located in J city. 154 participated and completed structured questionnaires from June 30 to July 18, 2022. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: The mean symptom experience score was 0.91±0.67 (out of 5), self-care agency was 4.19±0.71 (out of 6), and quality of life was 3.02±0.49 (out of 5). A negative correlation was found between quality of life and physical symptom experience (r=-.39, p<.001) and emotional symptom experience (r=-.39, p<.001). A positive correlation was found between quality of life and self-care agency (r=.66, p<.001). The regression analysis showed self-care agency (β=.48, p<.001), emotional symptom experience (β=-.27, p=.001), and monthly family income (β=.19, p=.002) significantly influenced quality of life, and explained 54.0% of the quality of life. Conclusion: These results suggest to improve the quality of life among patients on hemodialysis, it is necessary to assess and intervene with emotional symptom experiences and develop effective programs with specific strategies to enhance self-care agency.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.339-346
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• 2022

Backgrounds/Aims: To investigate if the increase in the number of cholecystectomies is proportional to symptomatic gallbladder-associated hospital admissions in Australia and Aotearoa New Zealand (NZ). Methods: National healthcare registries were used to obtain data on all episodes of cholecystectomies and hospital admissions for patients ≥ 15 years from public and private hospitals. Results: Between 2004 and 2019, in Australia, there have been 1,074,747 hospital admissions and 779,917 cholecystectomies, 715,462 (91.7%) of which were laparoscopic, and 163,084 admissions and 98,294 cholecystectomies in NZ. The 15-54 years age group saw an increase in operative rates, +4.0% in Australia and +6.6% in NZ, and admissions, +3.7% and +5.8%, respectively. Hospital admissions decreased by -9.8% in Australia but the proportion of patients undergoing intervention increased by 10.8% (from 67.1% to 75.0% of hospital admissions). Procedural rates increased by +7.3% in NZ with no change in the intervention rate. Conclusions: In Australia, there has been a decline in symptomatic gallbladder-associated hospital admissions and a rise in intervention rate. Admissions and interventions have increased proportionally in NZ. There are higher rates of cholecystectomy and admission amongst younger demographics, compared to historical cohorts. Future research should focus on identifying risk factors for increased disease and operative rates amongst younger populations.

• Journal of Radiation Protection and Research
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• v.32 no.2
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• pp.89-96
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• 2007

Radiation safety managements in medical institutions are needed to protect certain radiation damages as a part of National Coalition. This study investigates the characteristics of self-efficacy that become the major factor on the knowledge, attitude, and behavior on the radiation safety management of radiation workers as an approach of educational aspects and analyzes the relationship between such factors to provide basic materials for improving the activity level of radiation safety managements. In order to implement the goal or this study, a survey was performed for 1,200 workers who were engaged in radiation treatments in medical centers, such as general hospital, university hospital, private hospital, and public health center for 42 days from July 23,2006. Then, the results of the analysis can be summarized as follows: 1. Average scores on knowledge, attitude, and behavior in the radiation safety management were presented as $75.76{\pm}11.20$, $90.55{\pm}8.59$, $80.58{\pm}11.70$, respectively. Also, the average score of self-efficacy was recorded as $73.55{\pm}9.82$. 2. Knowledge levels in the radiation safety management showed significant differences according to the sex, age, marriage, education, and experience. Also, males of married, older, highly educated, and largely experienced represented high knowledge levels. Attitude levels in the radiation safety management showed certain significant differences according to the type of medical centers in which private hospitals showed a relatively low level compared to that of high levels in university hospitals. Behavior levels in the radiation safety management also represented significant differences according to the age, marriage, education, experience, and types of medical centers. Factors in married, general hospital, older, highly educated, and largely experienced showed high behavior levels. In addition, the self-efficacy showed certain differences according to the marriage and types of medical centers. Factors in married and general hospital demonstrated high self-efficacy levels. 3. Relationship between knowledge, attitude, behavior, and self-efficacy on the radiation safety management showed statistical differences according to the relationship between the knowledge and the attitude, the knowledge and the behavior, the attitude and the behavior, the attitude and the self-efficacy, and the behavior and the self-efficacy. The relationship between the behavior and the self-efficacy was represented as r = 0.482, which was the strongest relationship in such factors. Also, the knowledge and self-efficacy didn't show certain relationships.