• 한국지열·수열에너지학회논문집
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• 제16권4호
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• pp.1-8
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• 2020

For a central cooling system of a medical facility composed of absorption chiller and screw chiller, the study was conducted on how to minimize the energy cost. In consideration of the energy cost, the optimal operation method in which the operation method of the heat source is changed according to the size of the cooling load was derived through simulation analysis. When applying the optimal operation method, the indoor environment, energy consumption, and energy cost were analyzed and compared with the reference operation method.

• Genomics & Informatics
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• 제18권4호
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• pp.35.1-35.7
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• 2020

Identifying the patterns of gene expression in breast cancers is essential to understanding their pathophysiology and developing anticancer drugs. Breast cancer is a heterogeneous disease with different subtypes determined by distinct biological features. Luminal breast cancer is characterized by a relatively high expression of estrogen receptor (ER) and progesterone receptor (PR) genes, which are expressed in breast luminal cells. In ~25% of invasive breast cancers, human epidermal growth factor receptor 2 (HER2) is overexpressed; these cancers are categorized as the HER2 type. Triple-negative breast cancer (TNBC), in which the cancer cells do not express ER/PR or HER2, shows highly aggressive clinical outcomes. TNBC can be further classified into specific subtypes according to genomic mutations and cancer immunogenicity. Herein, we discuss the brief history of TNBC classification and its implications for promising treatments.

• Journal of Chest Surgery
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• 제50권5호
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• pp.363-370
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• 2017

Background: Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients. Methods: This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients. We also analyzed the risk factors for hospital mortality in the entire ECLS population using univariate and multivariate analyses to investigate the effects of transport. Results: All 44 patients were safely transported without adverse events. The average travel distance was 178.7 km, with an average travel time of 74.0 minutes. Early survival of the transported group seemed to be better than that of the in-house group, but the difference was not statistically significant (70.5% vs. 56.6%, p=0.096). The incidence of complications was similar between the 2 groups, except for critical limb ischemia, which was significantly more common in the transported group than in the in-house group (25.0% vs. 8.1%, p=0.017). After adjusting for confounders, being part of the transported group was not a predictor of early death (adjusted odds ratio, 0.689; p=0.397). Conclusion: Transportation of patients on ECLS is relatively safe, and the clinical outcomes of transported patients are comparable to those of in-house ECLS patients. Although matched studies are required, our study demonstrates that transporting patients on ECLS did not increase their risk of hospital mortality after adjustment for other factors.

• 한국의료질향상학회지
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• 제19권1호
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• pp.74-81
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• 2013

Research Problem: 45-65% of all medical supplies in hospital are used in operating rooms. Medical supplies in operating rooms are difficult to manage in general because many of them are frequently used and come in a variety of types. Purpose: Our aim was to strive for user-friendliness and reduce the inventory through efficient management of medical supplies stocked in operating rooms. Medical Facility: Korea University, Ansan Hospital Quality Improvement Activity: On the last day of each month, we checked the inventory of medical supplies in all operating rooms by identifying the amount of medical supplies in each room, warehouse, and OCS, identified problems, and presented the ways to improve. Improvement Outcome: We increased the number of post-processing medical supply items by 8%, and reduced the inventory cost by 15% through improved management of medical supplies.

• 한국컴퓨터정보학회논문지
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• 제15권8호
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• pp.89-98
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• 2010

인터넷을 기반으로 하는 웹의 급속한 발전으로 의료 환경에 중요한 변화를 가져오고 있다. 서로 다른 병원시스템을 가진 병원들이 의료 정보를 효율적으로 공유하고 교환할 수 있는 시스템이 요구되고 있다. 시스템 간 의료정보를 전달하기 위해서는 의료 데이터를 의료정보 교환 프로토콜인 HL7에 맞춰 변환시켜주는 인터페이스 엔진이 필요하다. HL7은 의료 정보 시스템간 데이터 교환을 위한 표준 프로토콜이다. 본 논문에서는 HL7에서 정의한 메시지 구조를 바탕으로 요양기관의 치매환자를 위한 인터페이스 엔진을 구현하였다. 인터페이스 엔진은 클라이언트와 서버 모듈로 구성하였다. 클라이언트 시스템에서는 환자의 의료 데이터 입력과 메시지를 생성하여 서버 시스템으로 전달하도록 하였고, 서버 시스템에서는 메시지를 세그먼트, 필드 단위로 파싱하여 메시지의 이상 유무를 클라이언트 시스템으로 전송하도록 구현하였다. 구현 언어로는 Java와 JavaCC를 사용하였다. 본 연구로 인하여 평생전자의무기록과 원격진료시스템, 다양한 의료기관 간 의료 정보를 공유할 수 있는 기반이 될 것이다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권4호
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• pp.31-39
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• 2022

The purpose of this study is to analyse the hazard risk by examining the magnitude and severity of each type of hazard in order to mitigate and prepare for disasters in medical facilities. Methods: The hazard risk analysis for hazard types was surveyed for team leaders of medical facilities. The questionnaire analyzed data from 27 facilities, which were returned from 41 Local Medical Centers. Results: When looking at the 'Risk' by category type of hazard, the influence of health safety and fire/energy safety comes first, followed by natural disaster, facility safety, and crime safety. On the other hand, as for 'Magnitude', facility safety and crime safety come first, followed by health safety, fire/energy safety, and natural disasters. Most of the top types of disaster judged to have high hazard in medical facilities are health types. The top five priorities of hazard in medical facilities, they are affected by the geographical and industrial conditions of the treatment area. In the case of cities, the hazard was found to be high in the order of infectious disease, patient surge, and wind and flood damage. On the other hand, in rural areas, livestock diseases and infectious diseases showed the highest hazard. In the case of forest areas, the hazard was high in the order of wildfire, fire accident, lightning, tide, earthquake, and landslide, whereas in coastal areas of industrial complexes, the hazard was high due to fire, landslide, water pollution, marine pollution, and chemical spill accident. Implications: Through the research, standards will be established for the design of hospitals with disaster preparedness, and will contribute to the preparation of preemptive measures in terms of maintenance.

• 의료법학
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• 제20권1호
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• pp.163-201
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• 2019

의사에게는 환자와의 법률관계에서 비롯되는 여러 의무들이 존재한다. 그 중 하나가 의사 자신이 속해 있는 의료기관이 치료 및 진료를 위한 인프라나 의료기술이 부족한 것으로 판단하는 경우 환자를 적절한 진단 검사 및 진료가 가능한 의료기관으로 '전원(轉院)'하여야 하는 주의의무인 전원의무(轉院醫務)이다. 의료기관마다 환자의 응급성 정도에 따라 대응할 수 있는 능력이 다르므로 의사의 지시나 권고에 의하여든 환자 본인의 요청에 의하여든 이와 같은 환자의 전원은 불가피한 현상이다. 예를 들어 심각한 뇌손상을 입은 환자가 내원한 경우, 진단, 검사 장비 및 인력을 갖추지 못한 병원의 의사로서는 적절한 시기(이른바 '골든타임')에 진단, 검사 및 진료가 가능한 상급의료기관으로 전원을 고려하여야 한다. 이처럼 전원의무는 의사의 의무 중 하나인 것으로 의사뿐만 아니라 환자들에게도 널리 인식되고 있다. 그러므로 적절한 전원 시점을 놓치게 되어 의료사고가 발생한 상황에서는 전원의무위반 여부와 관련한 의사와 환자 간의 법적 분쟁이 있을 수밖에 없다. 본 연구에서는 이러한 상황과 관련하여 전원의무에 대한 구체적이고도 명확한 판단 기준 정립과 함께 현재 각 의료기관들에 마련되어 있는 가이드라인이 실제 적용에서의 여러 시행착오들을 반영하고 있는지에 대한 검토가 필요하다고 보고, 의사의 전원의무에 대한 판례의 동향 분석을 중심으로 전원의무 관련 판례에서 이미 제시되어 있는 판단 기준 요소들이 적절한지 그리고 현재 실무에서 적용되는 법령 및 가이드라인 등과 부합되는지 여부를 살펴봄으로써 앞으로 응급환자에 대한 의사의 전원의무 관련 분쟁조정 및 소송에서의 해석과 적용에 기여할 수 있도록 하였다.

• 호스피스학술지
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• 제2권1호
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

• 대한응급의학회지
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• 제29권5호
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• pp.500-508
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• 2018

Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권3호
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• pp.27-35
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• 2020

Purpose: A solid system in the process of establishing guidelines can increase social acceptance and utilization. The paper aims to comparatively analyze the system in which guidelines for health care facilities in the US, Australia, and the UK and suggest implications for Korea. Method: It conducted literature analysis of the system in the framework of composition, governance, and procedure for the Facility Guidelines Institute's Guideline for US, Australia's Australasian Health Facility Guidelines for Australia, and Health Building Notes for UK. Results and Implications: First, in terms of composition, the guidelines for health care facilities can be divided into composition by space and composition by issue. It is proposed to establish a system that space and issues are clearly separated, such as Australia's AusHGF, and complete it step by step. Second, in terms of governance, despite the fact that the medical supply is privately oriented, the medical system is controlled by the government in Korea. Therefore, it is suggested to form a separate organization in the public sector that establishes, researches, and revises the guideline that will serve as a focal point for experts in various fields to participate. Third, in terms of procedure, it is suggested to establish a guideline that reflects the experiences and demands of consumers by clearly organizing procedures including collecting opinions.