• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.133-147
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• 2000

To provide data for the improvement of primary health care through the study on the utilization rate of community health practitioner(CHP) post and its related factors toward some rural residents in Mooan County Chollanamdo, a questionnaire survey was made from 382 persons during August 1999. Comparison was made between persons at the seaside area under difficult transportation and persons at the railroad area under convenient transportation. The results are as follows: 1. For the last one year, 83.3% of seaside area residents and 67.0% of railroad area residents used CHP post. As the purpose of visit to CHP post at seaside area, 94.3% visited for medical care, 25.3% for chronic disease control and 22.2% for health counselling and 14.1% for chronic disease control. 2. By simple analysis, sex, age, marital status, educational level, residence area, distance from living village to CHP post, presence of chronic diseases, satisfaction with CHP and confidence on CHP were related significantly with the utilization of CHP post for the last one year. 3. By multiple logistic regression, statistically significant variables related with the utilization rate of CHP post for the last one year were analyzed as age, sex, residence area and distance from living village to CHP post.

• Quality Improvement in Health Care
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• v.3 no.2
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• pp.36-51
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• 1997

Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

• The Journal of Korean Medical History
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• v.29 no.2
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• pp.35-47
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• 2016

"JeSeBoGam (濟世寶鑑)" was a medical document authored by Moon Gi-hong during the Japanese colonial rule in 1933, and the author acted as a Korean medicine doctor, an acupuncturist, a medicine practitioner and an apothecary. Since its first publication in 1933, it has been published three times in 1966 and 1975, from the Japanese colonial period to the liberation period. "JeSeBoGam" is largely divided into Preface part, "List of drugs according to symptoms [隨症用藥目錄]", "JeSeBoGam-Gap (濟世寶鑑甲)", and the Appendix includes "Key points for diagnosing the disease [察病要訣]" "Key points of acupuncture and pulse [脈訣]" "Key points of acupuncture and moxibustion treatment [針灸訣]" in the back of the book. In 1933, there are attached exam books and license application forms related to Korean medicine doctor and pharmacist, so strict regulations on them during the Japanese occupation period can be confirmed. "JeSeBoGam-Gap" contains 208 prescriptions from 143 prescriptions taken from "BangYakHapPyeon" and 65 prescriptions from other books. It divided into Gap (甲) Eul (乙) Byung (丙) Jung (丁). These prescriptions were placed in "List of drugs according to symptoms [隨症用藥目錄]" according to a symptom 1,286 times. Considerable parts of organization and prescription drug composition of "JeSeBoGam" are closely related with "BangYakHapPyeon", but there were adjustments in all medicinal ingredients and capacity for the rest of them except 23 prescription drugs. Compared to "BangYakHapPyeon", there was a tendency to substitute the basic prescription in "JeSeBoGam" for prescriptions used for the same disease. Though only 65 prescriptions were taken from books other than "BangYakHapPyeon", 575 times were reflected in "List of drugs according to symptoms [隨症用藥目錄]", and the rate of utilization is high compared with the number of prescriptions of "BangYakHapPyeon". It is thought that the circumstances of the Japanese occupation period, limits in medicinal ingredients composition due to regional characteristics, and changes in a patient's condition and the treatment method might have an influence on the author's drug use tendency. "JeSeBoGam" is similar to "BangYakHapPyeon" in composition, but it is a new practical medical book in which the author's clinical records are concentrated.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.83-107
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• 2019

This article focuses on §10 of Criminal Act of the Republic of Korea to discuss how to determine criminal responsibility of a perpetrator suffering from mental disorders, while reviewing existing process and standards of mental examination at each stage of the criminal procedure as well as exploring suggestions regarding how they should be complied. The determination of the sanity or criminal responsibility of the mentally ill as defined in the §10 of Criminal Act, by its nature, cannot be approached with a traditional, clear-cut dichotomy of biology by medical practitioner and psychology·normative science by lawyer. Looking into the actual procedure of determining mental and physical disorder with special consideration of mental illness reveals the inevitability of collaboration between lawyers and psychiatrists. In the meantime, the process and standards of mental examination at each stage of the criminal procedure must be definitive and clear. First of all, during the investigation stage, examination prior to prosecution should be more actively encouraged, considering that judging sanity of the perpetrator at the time of committing a criminal act is important. During the trial stage, the mandatory examination must be conducted depending on the sensitivity and gravity of the case. Next, medical examination to determine criminal responsibility and the one to order treatment and custody must be separately conducted in order to properly execute medical treatment and custody. Obligatory mental examination could be considered both during the stage of request for and execution of the treatment and custody. Lastly, the procedure of examination and format of examination documents need to be standardized for better objectivity and reliability.

• The Journal of Dong Guk Oriental Medicine
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• v.8 no.2
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• pp.175-199
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• 2000

Acupuncture and moxibustion play an important role not only in the medical service and health care of Korea, China and japan but also in those of many western countries such as Germany, France, United States of America. An unexpected results induced by careless acupuncture and moxibustion treatments may be mild or severe, and are due to practitioner's mistake and particular body condition of a patient. This study was performed to establish a preventive measures against medical accident induced by acupuncture therapy. Total 23 acupuncture points which are included in a J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ were selected as prohibited acupuncture points. Although the records in J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ are an important data historically which show dangerous acupuncture points, there are few a full investigation on J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ up to the present. So present study was done for literature review to understand a feasibility of the records in J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ in association with dangerous acupuncture points. Based upon the locations of these acupuncture points, the dangerous region were classified three categories, head, soma and limb. And abnormal signs related to the improperly performed acupuncture treatment on each point were investigated by using historical reference books on acupuncture and moxibustion. And then names, locations, depth of insertion, operation methods and side effects of each point were investigated.

• Journal of the Korean Institute of Oriental Medical Informatics
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• v.17 no.2
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• pp.130-287
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• 2011

"zhenjiusunanyaozhi(鍼灸素難要旨)" is composed of three volumes and published in 1529 by Gao Wu(高武). Gao Wu(高武) is skillful in astronomy, the art of war and the law as well as a medical practitioner in Ming Dynasty. The books he wrote "zhenjiujuying(鍼灸聚英)", "zhizhi(直指)", "douzhenzhengzong(痘疹正宗)", "shexuezhinan(射學指南)", "zhenjiujieyao(鍼灸節要)". "zhenjiusunanyaozhi鍼灸素難要旨" is written by classifying the origin of acupuncture and moxibustion. In other words, it is edited by classifying the contents related to acupuncture and moxibustion out of the ancient Chinese medical book "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" in which are composed of 3 volumes as follows, Volume 1 says the main diseases on "the nine acupuncture needles figure" (九針圖), "the reinforcing and reducing the meridian" (補瀉), "the needle depth" (針刺深淺), "the five shu points - metal, wood, water, fire, earth" (正,滎,輸,經,合) based on 18 chapters in terms of acupuncture in "yellow emperor eighty-one Difficult "難經"", in which it quotes the annotation of "the difficulty by the original meaning "難經本義"" written by Hua Shou(滑壽) in Yuan Dynasty. Volume 2 is composed of 2 parts. Part 1 says the method of treatment on 36 Chapters, the method of acupuncture use in the Linshu "靈樞" and the Suwen "素問" such as "the rule of acupuncture use" (用針方宜), "the nine-pin method" (九針式) and "the nine-pin to only use the time appropriate to consider nature of Heaven, Earth and person" (九針應天地人時以起用) etc., Part 2 says "the five difficult acupuncture(五亂刺)", "the rise and fall of energy and blood(氣血盛衰)". "the pain tolerance(耐痛)" and ect., in which are in terms of method of treatment collected the original texts of 59 chapters on acupuncture to each disease and of 8 chapters on moxibustion in the Linshu "靈樞" and the Suwen "素問". Volume 3 includes 10 chapters in which consist of "the stabbing to disease in 12 meridians (十二經病刺)", "the eight extra meridian disease (寄經八脈病)", "the twelve meridians(十二經脈)", "the fifteen collaterals (十五絡脈), the twelve meridian muscles (十二經筋)", "the acupoint (孔穴)" and etc. This is the book edited comprehensively by classifying the contents on the theory of acupuncture and moxibustion and the circulations of meridians in "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" and there is no case story in particular except his comments in person. This study is for the purpose of helping researching and developing acupuncture and moxibustion and applying their clinical training.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.133-162
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• 2019

Due to the nature of medical malpractice lawsuits, it is difficult for medical consumers, who are weak in getting information when it comes to health care problem, to secure all information inside the hospital. Even if you are confident about the hospital infection, it is true that people have difficult to obtain medical testimony by expert. It is seen as no easy task to testify to the malpractice of colleagues who work in the same field not only in our country but also abroad, when a doctor gives negative testimony to another doctor in a medical malpractice lawsuit. Although few health care providers will be motivated to take medical care from the outset, testimony or statements from a medical practitioner can have a significant impact on the outcome of a lawsuit, as it is impossible for the patient to control or be aware of the whole process of medical conduct, especially in the event of a hospital infection and the victim. If the hospital can prove the causality of damages caused by negligence of the employees or supervision of the hospital itself in a medical suit caused by the infection, the level of protection of the victim could be raised further. We sought to find a solution to these problems by looking at the provisions of other laws related to hospital infection. In particular, as the comparative legal review regarding hospital infection, Germany's legislative precedent sets a medical contract as a typical civil law contract, so it is thought that looking at German civil law regulations also has implications for Korean law. We also tried to improve the French Special Act 'rights of patients' and we can look at the consequent changes in court cases. Finally, the content of the U.S. case's and the theory of 'the doctrine of res ipsa loquitur' in relation to it show that doctors and hospitals have been forced to shift the burden of proof through this theory. This paper tried to find out the implications of mitigating the burden of proof by reviewing various issues that might be related to medical litigation of hospital infection from a comparative point of view.

• Health Policy and Management
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• v.3 no.2
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• pp.100-129
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• 1993

This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.

• Journal of Convergence for Information Technology
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• v.10 no.2
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• pp.184-192
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• 2020

This study presents a gait analysis method (including time series analysis) using a smart insole as an objective and quantitative evaluating method after lumbar scoliosis surgery. The participant is a degenerative lumbar scoliosis patient. She took 3-min-gait-test four times(before and 8, 16, and 204-days after surgery) and 6-min-gait-test once(204-days after surgery) with smart-insoles in her shoes. Each insole has 8-pressure sensors, an accelerometer, and a gyroscope. The measured values were used to compare the characteristics of gait before and after surgery. The analysis showed that all of the patient's gait parameters improved after surgery. And after 6 months, the gait was more stable. However, after long walk, the swing duration of one leg was slightly shorter than that of the other again. It was a preclinical problem that could not be found in the visual examination by the practitioner. With this analysis method we could evaluate the improvement of patient quantitatively and objectively. And we could find a preclinical problem. This analysis method will lead to the studies that define and distinguish gait patterns of certain diseases, helping to determine appropriate treatments.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.507-519
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• 2003

Purpose: The purpose of this study was to identify the prevalence, health behaviors, and control of hypertension in rural areas in Korea. Method: A total of 927 subjects above age 20 were selected from the areas which fell under the jurisdiction of the 24 Community Health Center located in Chungcheongbuk-do. The employees in the Community Health Center visited and interviewed patients. Data were collected using a questionnaire from July to October 2002. Result: The result showed that women had higher hypertension prevalence rates than men and the increment of its rate leveled up according to age. The hypertension prevalence rate was significantly high when the monthly income was less than 1 million won, their type of the Medical Insurance was the Guardian, they were only able to read Korean characters, and they were bereaved of spouses. In the Health behavior related to hypertension, the hypertension group showed a significantly lower level than the non- hypertension group in terms of drinking rate, smoking rate, intake of salt and intake of meat. There was no significant difference in the exercise rate and coffee intake rate between these groups. In the degree of the obesity the hypertension group was significantly higher than the non-hypertension group. The factors related to hypertension were that the duration for the incidence of hypertension was 12 to 60 months and took up 41.2%. The places where the medical check-ups occurred were the Community Health Center at 46.6%, the medical institution was mostly hospitals recording 46.5%. There were 66.1% of the targets who knew well about their blood pressure and there were 64.7% people who received education about it. As for the education place, the rate of Community Health Center was mostly high and it stood at 77.0%. In the aspect of the management of hypertension, the targets who took medicine on a regular basis were up to 76.1% and the targets who measured blood pressure once a month happened to be about 46.1 %. The targets who always recorded their blood pressure were 3.8%, chest X-ray as a related examination of hypertension reached 32.6%, electrocardiogram examination was 36.2%, cholesterol and serum lipid examination took up 33.6%, and the eye ground examination took 7.3%, which showed the lowest level of all.