• 제목/요약/키워드: Management of medical institute

Search Result 1,931, Processing Time 0.035 seconds

Corona 19 Crisis and Data-State: Korean Data-State and Health Crisis Governance (코로나19 위기와 데이터 국가: 한국의 데이터 국가와 보건위기 거버넌스)

  • Jang, Hoon
    • Korean Journal of Legislative Studies
    • /
    • v.26 no.3
    • /
    • pp.125-159
    • /
    • 2020
  • Amid global pandemic of covid-19, Korean government's response has drawn wide attention among social scientists as well as medical studies. The role of Korean state and civil society has attracted particular attention among others. Yet, this paper criticizes extant studies on Korean case which focus on the extensive intervention of the strong state and subjective attitude of Korean citizens in coping with covid-19. The concept of the strong state lacks social scientific specification and subjective citizens do not match with Korean realities. This article argues that Korean state's capacity in collecting and mobilizing digital data may offer better understanding for the successful responses to the pandemic. First, Korean state is the ultimate coordinator in collecting, analyzing and applying big data about the expansion of covid-19 with its huge network of dataveillance. Also, such role has been largely based upon relevant legal framework and well prepared manuals and cooperation with civic actors and companies. In other words, Korean digital dataveillance had demonstrated its transparency and cooperative governance. Second, such dataveillance capacity has deep roots in the long-term development of Korean state's big data management. Korean state has evolved about thirty years while enhancing digital data network within governments, companies and private sectors. Third, the relationship between Korean state's dataveillance and civil society can be characterized as a state centered push model. This model demonstrates highly effective governmental responses to covid-19 crisis but fall short of building social consensus in balancing individual freedom, human rights and effective containment policies. It means communitarian solidarity among citizens has not been a major factor in Korea's successful response yet.

Study on Frailty Profiles and Associated Factors in Later Adulthood (노년기 허약 유형과 영향요인에 관한 연구)

  • Kim, Young-Sun;Kang, Eunna
    • 한국노년학
    • /
    • v.38 no.4
    • /
    • pp.963-979
    • /
    • 2018
  • The purpose of this study was to identify frailty profiles based on physical, psychological, and social domains of functioning and to examine the associated factors showing the differences among frailty profiles. Respondents were 70 years and older(n=403) and latent class analysis was applied to determine the optimal subgroups based on Tilberg Frailty Indicators which comprised of three domains(the physical, psychological, and social domain). Also, we performed multinominal logistic regression analysis to find out factors making differences among frailty profiles. Latent class analysis(LCA) identified three distinct types: multi-frail type(27.0%), psychologically frail type(26.8%), inadequate support type(46.2%). All three types had common difficulties in dealing with daily life problems and did not receive enough help with theses difficulties. Based on the results of the LCA three-class models, people in multi-frail type accumulated problems in physical and psychological domains and had partially social domain. On the other hands, psychologically frail type showed a relatively high anxiety disorder and depression. Lastly, people in inadequate support type reported the lack of helps, but they were relatively healthy. Comparing these groups with inadequate support type, people with multi-frail had lower educational level, poor nutritional management status and were less likely to participate in labor market. People in psychologically frail type were more likely to be male, to live in big cities rather than middle and small cities, and less likely to smoke. Based on these results, our results showed the multifaceted concept of frailty among Korean elderly people and we suggested several implications for preventing frail process.

Study on low-level laser therapy device according to the obesity development (비만치료기 개발에 따른 저준위레이저에 관한 연구)

  • Lee, Sang-sik;Kim, Jun-tae;Jeong, Jin-hyoung;Kim, Nam-Sun
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
    • /
    • v.9 no.1
    • /
    • pp.82-89
    • /
    • 2016
  • And by entering into an aging society with economic growth "beautiful and healthy desire to live', aesthetics industry as promote interest in 'Anti-aging' is emerging as a promising business increased significantly the skin care market. However, the management of the hospital or the temporal order to receive professional care providers, spatial, and cost constraints caused many companies to solve this problem began to approach the Home Care Area. Global trends in personal skin care market has been activated, the domestic has been activated at low cost, private market due to the recession. We have performed this test in order to develop a skin care device for home in order to compensate for this point.In this paper, we develop a low-level laser to create a personal skin care products and sought to incorporate them into the skin cosmetic.Expand the pores by using the low-level laser to the skin by to the dermal layer of the skin was penetrated aim experiment the ampoule, and by a comparison of the medical low-level laser reliability and determine the effectiveness or absence of the performance and efforts to commercialize.

Implementing an Adaptive Neuro-Fuzzy Model for Emotion Prediction Based on Heart Rate Variability(HRV) (심박변이도를 이용한 적응적 뉴로 퍼지 감정예측 모형에 관한 연구)

  • Park, Sung Soo;Lee, Kun Chang
    • Journal of Digital Convergence
    • /
    • v.17 no.1
    • /
    • pp.239-247
    • /
    • 2019
  • An accurate prediction of emotion is a very important issue for the sake of patient-centered medical device development and emotion-related psychology fields. Although there have been many studies on emotion prediction, no studies have applied the heart rate variability and neuro-fuzzy approach to emotion prediction. We propose ANFEP(Adaptive Neuro Fuzzy System for Emotion Prediction) HRV. The ANFEP bases its core functions on an ANFIS(Adaptive Neuro-Fuzzy Inference System) which integrates neural networks with fuzzy systems as a vehicle for training predictive models. To prove the proposed model, 50 participants were invited to join the experiment and Heart rate variability was obtained and used to input the ANFEP model. The ANFEP model with STDRR and RMSSD as inputs and two membership functions per input variable showed the best results. The result out of applying the ANFEP to the HRV metrics proved to be significantly robust when compared with benchmarking methods like linear regression, support vector regression, neural network, and random forest. The results show that reliable prediction of emotion is possible with less input and it is necessary to develop a more accurate and reliable emotion recognition system.

Generation, Storing and Management System for Electronic Discharge Summaries Using HL7 Clinical Document Architecture (HL7 표준임상문서구조를 사용한 전자퇴원요약의 생성, 저장, 관리 시스템)

  • Kim, Hwa-Sun;Kim, Il-Kon;Cho, Hune
    • Journal of KIISE:Databases
    • /
    • v.33 no.2
    • /
    • pp.239-249
    • /
    • 2006
  • Interoperability has been deemphasized from the hospital information system in general, because it is operated independently of other hospital information systems. This study proposes a future-oriented hospital information system through the design and actualization of the HL7 clinical document architecture. A clinical document is generated using the hospital information system by analysis and designing the clinical document architecture, after we defined the item regulations and the templates for the release form and radiation interpretation form. The schema is analyzed based on the HL7 reference information model, and HL7 interface engine ver.2.4 was used as the transmission protocol. This study has the following significance. First, an expansion and redefining process conducted, founded on the HL7 clinical document architecture and reference information model, to apply international standards to Korean contexts. Second, we propose a next-generation web based hospital information system that is based on the clinical document architecture. In conclusion, the study of the clinical document architecture will include an electronic health record (EHR) and a clinical data repository (CDR), and also make possible medical information-sharing among various healthcare institutions.

Clinical Comparison of $Henoch-Sch\"{o}nlein$ Purpura Nephritis in Children and Adults (소아와 성인 $Henoch-Sch\"{o}nlein$ Purpura(HSP) 신염의 임상적 비교)

  • Kim Ki-Eun;Shin Youn-Ho;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
    • /
    • v.7 no.2
    • /
    • pp.157-165
    • /
    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.

  • PDF

Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction (중등도 이상의 좌심기능부전 환자에서 승모판성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
    • /
    • v.36 no.11
    • /
    • pp.812-819
    • /
    • 2003
  • Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Paula Murphy;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
    • /
    • v.28 no.1
    • /
    • pp.70-79
    • /
    • 2024
  • Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

The Assessment on Health Status of Workers by using HPLP and Sa-sang Constitutional Questionnaire (HPLP와 사상체질설문(四象體質說問)을 이용(利用)한 근로자(勤勞者)들의 건강상태(健康狀態) 평가(評價))

  • Choi Mun-Il;Lee Eun-Kyoung;Kwon So-Hee;Ko Kwang-Jae;Seo Byeong-Yun;Jeoung Jae-Yeal;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.5 no.1
    • /
    • pp.41-56
    • /
    • 2001
  • Overview: The purpose of this study was to evaluate the determinants on the correlation between constitution and health promoting lifestyle profile on the workers. Also, the questionnaire on the HPLP (health promoting lifestyle profile) of Walker(1987) and Sa-sang constitution of Lee(l894) were utilized Methods: Data from a representative sample of 652 workers were analyzed Pearson's chi-square test analysis was utilized to test the explanatory causal model and to determine the direct and indirect effects of independent variables on quality of life. Results: Constitutional distribution among exposed group, were Tae-eum In(43.7%), So-eum In(33.6%), and So-yang In(22.7%). The degree of the subjects practicing health promoting lifestyle, on a scale of 1 to 4, is an average of 2.62, personal relations 2.94, self-realization 2.86, stress management 2.71, nutrition 2.68, responsibility for health 2.37, and exercise 2.21, with personal relations earning the highest points and exercise the lowest As for factors influencing health promoting lifestyle, there is significant difference between sex and age. That is female and higher age. On the difference between constitution and health promoting lifestyle, Tae-eum In is the highest all area except personal relations. So-eum In is the lowest all area except responsibility for health. Conclusions: Tae-eum In totally do health promoting lifestyle well but So-eum In relatively not. On the Study we used the HPLP(health promoting lifestyle profile) on the premise that each person's daily life, the attitude and the practice level to the health have an influence on the health. So in the constitution there is a little differences in the consideration and the practice level and health condition will be different. On this study we finish up by knowing about the health promoting lifestyle. But on next time we will have to go on studying about the sign and the comparison with the result of western and oriental medical health examination to the each constitution on carrying out continuously oriental medical health examination.

  • PDF

Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
    • /
    • v.26 no.1
    • /
    • pp.1-9
    • /
    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.