• The Journal of the Korea Contents Association
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• v.18 no.9
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• pp.399-410
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• 2018

This study is a methodological approach to the study of a customer experience-based Tuberculosis(TB) management service design for a local public medical institution, with the application of the service design process by the Design Council in the UK. This study designed a TB management service for a local public medical institution using the service design method which identifies and resolves TB management-related problems based on experiences of medical personnel of TB facilities as well as of TB patients. To design a TB management service for the whole process from hospitalization to discharge and then to cooperation with local communities, a team was formed with 12 TB management-related personnel. The team went through the four phases of service design process: Discover, Define, Develop and Deliver. In addition, the TB management service based on customer experience was developed that included eight services related to processes from hospitalization to discharge and cooperation with local communities. According to the study results, a service design methodology was found to be considerably effective in developing a service program that takes into account an overall circumstance of various relevant personnel as well as patients. It is suggested that further studies use a service design methodology in developing various health management service programs in need of improvement of work efficiency among relevant personnel as well as providing the best satisfaction for customers by identifying hidden needs based on their experiences.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.4
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• pp.299-307
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• 2015

Severe acute pancreatitis (SAP) is normally related to multiorgan dysfunction and local complications. Studies have found that local pancreatic renin-angiotensin system (RAS) was significantly upregulated in drug-induced SAP. The present study aimed to investigate the effects of angiotensin II receptors inhibitor valsartan on dual role of RAS in SAP in a rat model and to elucidate the underlying mechanisms. 3.8% sodium taurocholate (1 ml/kg) was injected to the pancreatic capsule in order for pancreatitis induction. Rats in the sham group were injected with normal saline in identical locations. We also investigated the regulation of experimentally induced SAP on local RAS expression in the pancreas through determination of the activities of serum amylase, lipase and myeloperoxidase, histological and biochemical analysis, radioimmunoassay, fluorescence quantitative PCR and Western blot analysis. The results indicated that valsartan could effectively suppress the local RAS to protect against experimental acute pancreatitis through inhibition of microcirculation disturbances and inflammation. The results suggest that pancreatic RAS plays a critical role in the regulation of pancreatic functions and demonstrates application potential as AT1 receptor antagonists. Moreover, other RAS inhibitors could be a new therapeutic target in acute pancreatitis.

• Korea Journal of Hospital Management
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• v.16 no.2
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• pp.78-97
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• 2011

The purpose of this study is to analyze activating factors of medical tourism at Busan, and then decide on priority on the factors. As research methods, this study deduced priority of specialists' opinions by AHP analysis technique through structuralized questionnaire on the medical tourism's factors having been suggested from existing prior studies. The analysis results were same as followings. First, as a result of analysis on the main criteria, relative levels of importance were appeared high such as 'competitiveness', 'policy assistances from the government', 'medical care's infrastructure', and 'connectedness with regions' in order. Second, as a result of integrated results analyzing detailed criteria on the main evaluation standards, relative levels of importance were appeared high such as 'medical quality', 'health-related institution's improvement', 'medical infrastructure', 'medical charge', 'tourism-related institution's improvement', 'convenience', 'medical cooperation possibilities', and 'local industry compliance' in order. In conclusion, it is judged that activation of medical tourism shall be propelled after considering relative levels of importance on many policies or activating factors same as suggested in this study.

• Journal of Digital Convergence
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• v.14 no.11
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• pp.225-232
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• 2016

The purpose of this study is to analyze the effect of the glass ceiling induction factors on the improvement of the job Commitment on the glass ceiling perception and to analyze the effect of the organizational Commitment on the influence of the local medical institute and private medical institute employees. Purpose. As a research method, structural equation model analysis was carried out to investigate the influence relationship of each factor. In particular, multiple group analysis was performed to analyze the difference of influence relations between public and private medical personnel. Respectively. Result, First, empirical studies on the effect of the glass ceiling inducing factors on job Commitment showed that job Commitment was influenced by stereotype and organizational culture, and the magnitude of the influence was different. Second, the employees of the room medical center were influenced by perceived promotion, job placement, education and training, reward, and job satisfaction. Third, in the hypothesis that job Commitment will be affected by the perception of glass ceiling, only the workers of the private medical center showed significant results. Based on the results of this study, it will be necessary to plan policies to improve the perception of the glass ceiling phenomenon and improve its status in order to improve the personnel and system that women workers in the medical field can enter more senior management positions.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.584-595
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• 2021

Objective: Immune checkpoint inhibitor (ICI) therapy has shown activity against melanoma brain metastases. Recently, promising results have also been reported for ICI combination therapy and ICI combined with radiotherapy. We aimed to evaluate radiologic response and adverse event rates of these therapeutic options by a systematic review and meta-analysis. Materials and Methods: A systematic literature search of Ovid-MEDLINE and EMBASE was performed up to October 12, 2019 and included studies evaluating the intracranial objective response rates (ORRs) and/or disease control rates (DCRs) of ICI with or without radiotherapy for treating melanoma brain metastases. We also evaluated safety-associated outcomes. Results: Eleven studies with 14 cohorts (3 with ICI combination therapy; 5 with ICI combined with radiotherapy; 6 with ICI monotherapy) were included. ICI combination therapy {pooled ORR, 53% (95% confidence interval [CI], 44-61%); DCR, 57% (95% CI, 49-66%)} and ICI combined with radiotherapy (pooled ORR, 42% [95% CI, 31-54%]; DCR, 85% [95% CI, 63-95%]) showed higher local efficacy compared to ICI monotherapy (pooled ORR, 15% [95% CI, 11-20%]; DCR, 26% [95% CI, 21-32%]). The grade 3 or 4 adverse event rate was significantly higher with ICI combination therapy (60%; 95% CI, 52-67%) compared to ICI monotherapy (11%; 95% CI, 8-17%) and ICI combined with radiotherapy (4%; 95% CI, 1-19%). Grade 3 or 4 central nervous system (CNS)-related adverse event rates were not different (9% in ICI combination therapy; 8% in ICI combined with radiotherapy; 5% in ICI monotherapy). Conclusion: ICI combination therapy or ICI combined with radiotherapy showed better local efficacy than ICI monotherapy for treating melanoma brain metastasis. The grade 3 or 4 adverse event rate was highest with ICI combination therapy, and the CNS-related grade 3 or 4 event rate was similar. Prospective trials will be necessary to compare the efficacy of ICI combination therapy and ICI combined with radiotherapy.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.31-34
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• 2016

Rosai-Dorfman disease is a rare histiocytic disorder, clinically characterized by massive, bilateral painless cervical lymphadenopathy with potential for extranodal manifestations. We report a 45-year-old male patient who presented with a slowly growing erythematous nodule of the left chin. The mass appeared non-vascular on computed tomography study, but ultrasonogram was suggestive of a vascular lesion. The lesion was excised with presumptive diagnosis of a hemangioma. However, histopathologic examination of the surgical biopsy revealed histiocytic infiltration with emperipolesis, which was pathognomic for Rosai-Dorfman disease. Additional imaging studies did not reveal lymph node enlargement or other extranodal manifestation. The patient was diagnosed with cutaneous form of the Rosai-Dorfman disease and was discharged home. He remains free of local recurrence at 8 months.

• Herbal Formula Science
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• v.18 no.1
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• pp.57-77
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• 2010

Objective : This study reviews the recent trend of oriental medical prescription research. The data examined are the articles published in the Korean Journal of Oriental Medical Prescription from 1990 to 2009. Method : The data are retrieved through the internet database Oriental Medicine Advanced Searching Integrated System (OASIS) and the collection of the Korean Journal of Oriental Medical Prescription. The number of articles examined is 385, published in 25 volumes of the journal. This study examines the nature of the articles, research methods, subjects, and author information. Research subjects are sorted out by the OASIS key words for the articles published before 1999, and by key word indexes cited in the abstracts for the articles published sinceafter. Results : Among the 385 articles collected, 206 are research articles, 143 philological articles, 35 case studies, and 1 special contribution. A majority of research articles are experimental studies (199 articles or 96.6%), while clinical reports (5 articles or 2.43%), and others studies (2 articles) occupy a small portion. Most of experimental studies (183 articles or 91%) examine the effectiveness of certain prescriptions or treatments. Among the effectiveness studies, 114 articles (62.3%) employ in vivo experiment design, 52 articles (28.42%) in vitro experiments, and 17 articles (9.29%) both in vivo and in vitro experiments. In terms of research subject, the most frequently indexed key words are hepatotoxicity among diseases (9 articles), Bojungikgitang (Bu-Zhong-Yi-Qi-Tang) among prescriptions (10 articles), Buja (Acontii Tuber) among meteria medica (4 articles), immunity and anti-oxidation among efficacy terminology (6 articles each), and Donguibogam(東醫寶鑑) among references in the key words (25 articles). Universities are the main affiliation of authors (76.42%), followed by university hospitals (6.71%), non-academic research institutes (5.55%), local clinics (4.67), academic research institutes (2.81%), hospitals (2.38%), and others (1.44%). The most affiliated institute of the first and correspondent authors is Wonkwang University. In terms of authorship, co-authorship outnumbers sole-authorship by 82.08% to 17.92%. The proportion of authors of a single article is 63.54% which is near the author productivity distribution described by Lotka's law.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.54-58
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• 2007

Purpose: Luciferase is one of the most commonly used reporter enzymes in the field of in vivo optical imaging. D-luciferin, the substrate for firefly luciferase has very high cost that allows this kind of experiment limited to small animals such as mice and rats. In this current study, we validated local injection of D-luciferin in the articular capsule for bioluminescence imaging in rabbits. Materials and Methods: Chondrocytes were cultured and infected by replication-defective adenoviral vector encoding firefly luciferase (Fluc). Chondrocytes expressing Fluc were injected or implanted in the left knee joint. The rabbits underwent optical imaging studies after local injection of D-luciferin at 1, 5, 7, 9 days after cellular administration. We sought whether optimal imaging signals was could be by a cooled CCD camera after local injection of D-luciferin. Results: Imaging signal was not observed from the left knee joint after intraperitoneal injection of D-luciferin (15 mg/kg), whereas it was observed after intraarticular injection. Photon intensity from the left knee joint of rabbits was compared between cell injected and implanted groups after intraarticular injection of D-luciferin. During the period of imaging studies, photon intensity of the cell implanted group was 5-10 times higher than that of the cell injected group. Conclusion: We successfully imaged chondrocytes expressing Fluc after intraarticular injection of D-luciferin. This technique may be further applied to develop new drugs for knee joint disease.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.