• 대한한의학원전학회지
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• 제21권2호
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• pp.1-20
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• 2008

The Song Dynasty(宋代) period gained the summit in the developmental phase of the history in pediatrics. In 1076, Taeuiguk(太醫局) was founded and Sobangmaek(小方脈) was the one of nine branch in Taeuiguk(太醫局). As a result, educational agency and system was arranged in the field of pediatrics. At the same time, pediatrics have furnished with foundation to develop independent field in medical science. Especially, Byeonjeungnonchi(辦證論治) system is established in pediatrics science according to the compilation of "Soayakjeungjikgyeol(小兒藥證直訣)" by Jeoneul(錢乙). Children's doctors, Jeoneul(錢乙), Jinmunjung(陳文中) and Donggeup(董汲) arranged clinically theories, so they made that age the peak of the pediatrics. Looking at the developmental part of theory in pediatrics of the Song Dynasty period, Jeoneul(錢乙), who was the representative children's doctor in Song Dynasty period, insisted that children had formed Ojang-yukbu(五臟六腑) in the physiological part but they were not perfect like adult's. Therefore they had to consider the poor part in children's body, and then they had to cure them. 'Byeonjeung(變蒸)' was considered to be normal physiological phenomenon. Also he insisted that Yukeum(六淫), 'Pung, Han, Seo, Seup, Jo, Hwa(風, 寒, 暑, 濕, 燥, 火)' and 'Gyeong, Pung, Gon, Cheon, Heo(驚, 風, 困, 喘, 虛)' are the main cause of the children's five vital organ's pathology Like this, his academic thought, which lay emphasized on children's spleen and stomach and Ojangbyeonjeung(五臟辦證) main principles, affected on doctors, Donggeup(董汲), Yeomhyochung(閣孝忠), Yubang(劉肪), Jang-wonso(張元素), Idong-won(李東垣), Manjeon(萬全). Bangje(方劑) fields of pediatrics had developed so fast and "Taepyeongsunghyebang(太平聖惠方)" contained about 2689 kinds of children's prescription. According to this, there are so many kinds of medicinal shape, for example 'Hwan, San, Go, Dan(丸, 散, 膏, 丹)', which cured children' s disease. Through this, we find that the shape of medicine about the children's diseases had developed to the more simple direction, taking account of the children's clinical trait.

• 보건행정학회지
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• 제5권1호
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• pp.31-58
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• 1995

The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

• Journal of Korean Dental Science
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• 제2권2호
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• pp.18-23
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• 2009

Introduction : The purposes of this study were to analyze the differences between the anterior and posterior overjets using bracket slot points, and compare two methods of overjet calculation according to different reference points using clinical bracket points on three-dimensional digital models. Methods : A total of 35 normal occlusion models were scanned using a three-dimensional scanner (Orapix$^{(R)}$, Orapix Co., Ltd, Seoul, Korea) and then, virtual brackets (0.022" Slot MBT preadjusted brackets, 3 M Co.CA. USA) were placed on the digital models using virtual setup program (3Txer$^{(R)}$ ver. 1.9.6, Orapix co., Ltd). Archwire-like curves were designed to analyze labial and buccal overjet. Results : There were no statistically significance differences between the right and left overjet and between genders. The average overjet was found to be $1.67{\pm}0.85mm$ at the central incisor area, $2.16{\pm}0.88mm$ at the second premolar and $1.53{\pm}0.71mm$ at the first molar. Conclusion : It is recommended that overjet of individualized upper and lower arch to be 2.0mm at the anterior and posterior teeth.

• 대한약침학회지
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• 제11권3호
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• pp.33-45
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• 2008

Objective: To review the clinical basis of the Sa-Ahm 5 Element acupuncture originated about 360 years ago, papers and books were researched. Methods: Total of 58 books and papers ranging from ancient Huang Di nei jing to modern Bio Medical Acupuncture for Pain Management were investigated to study the clinical practice of it. Results: It could be practiced differently depending upon the viewpoints of diagnosis. They are ranging from theories of the greater-less of Yin and Yang, 7 emotions, organs- visceras, 8 diagnostic criteria, and pulse diagnosis to meridian circulation. Conclusions: It needs to be set clinical guidelines by which to practice Sa-Ahm acupuncture though it is nowadays mostly-used method in accordance with practitioner's viewpoints.

• 여성건강간호학회지
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• 제12권2호
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• pp.87-96
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• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• 한국농촌간호학회지
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• 제8권1호
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• pp.25-32
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• 2013

Purpose: The purpose of this study was to investigate the changing process of work activities of community health practitioners in medically vulnerable areas. Methods: For the study an historical research method was used, based on literature data and collected literature data related to the work of community health practitioners from 1940 to 2013. Results: There were 45 records according to the literature data about the work activities of the practitioners. Analysis of the process of work activities by time period was based on the historical records: first, the introduction period (1940~1980) saw the "community health practitioners begin their work activities"; second, the development period (1981~1997) involved "provision of comprehensive health and medical service"; third, the stagnation period (1998~2005) characterized by "attempts at new role changes in a crisis"; fourth, the expansion period (2006~2011) "focused on the work of health promotion"; and finally, the stable period (2012~the present) observed "work activities of community health practitioners recognized." Conclusion: Results showed five topics in the process of work activities of community health practitioners by time period. The results offer basic data to investigate work activities of these practitioners and enable discussions about the future of community healthcare.

• 대한한의학방제학회지
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• 제13권1호
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• pp.85-101
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• 2005

Kamiondamtang(KODT) has been used in oriental medicine as stress by many medical practitioner for the study of KODT, we had fed mice divided to three groups(basal diet, hyperlipidemic diet, hyperlipidemic diet + KODT), and observed the change of weight, total cholesterol, triglyceride, SGOT, SGPT, HDL-cholesterol, LDL-cholesterol on the serum per every 7days for 6weeks. To help comparison with the results above, we had tested endothelial cells and liver. The results of this Study were obtained as fallows ; 1. Total cholesterol, triglyceride and LDL-cholesterol were decreased significantly by KODT. 2. HDL-cholesterol was increasd significantly by KODT. 3. SGOT was intended to decrease by KODT, 4. %W was decreased significantly by KODT. 5. In case of supplying KODT, WBC attatched on endothelial cells and vacuoles in muscular layer were not observed. 6. In case of supplying KODT, fatty degeneration was not observed in liver portal area.

• 중환자간호학회지
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• 제7권1호
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• pp.24-32
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• 2014

Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

• 대한한의학방제학회지
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• 제20권2호
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• pp.165-176
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• 2012

In pathologically analyzing, 'Qi(氣)' is fall downed 'Zheng-Qi(正氣; Base energy of human body)' or 'Wai-Gan-Xie-Qi(外感邪氣; poisoned energy from outside of human body)'. And all extroverted symptoms from this 'Qi(氣)' is 'Shang-Chong(上衝)'. Also this symptom's basic mechanism is deficiency of 'Zhong-yang(中陽; basic active energy acting pivot)' by non-proper 'Xia-fa(下法; treatment way getting out focus to down side)' at early days of 'Tai-Yang-bing (太陽病; Primary stage symptoms when the cold energy of the outside tresspasses the external layer of body)'. And comparing herbs in medicines for treating 'Shang-Chong(上衝)' in Shang han lun with Japanese in Shang-han medical practitioner's view, there is 'Ping-Chong(平衝; Supress out bursting energy)''s effect when use 'Gui-zhi(桂枝; Cinnamomum cassia loureirii zeylanuicum)' for mass dosage. Based on these, 'Qi-Shang-Chong(氣上衝)' means all of the symptom's aspects which called 'Yang(陽)''s aspect that is extrovesity, dynamic and imminent by results of the experiment about Cinnamaldehyde which are the main ingredients of 'Gui-zhi(桂枝; Cinnamomum cassia loureirii zeylanuicum)' and clinical data of 'Gui-zhi-tang(桂枝湯)'.

• 보건의료산업학회지
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• 제14권1호
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• pp.93-102
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• 2020

Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.