• Health Policy and Management
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• v.14 no.2
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• pp.138-162
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• 2004

This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

• Medical Lasers
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• v.9 no.1
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• pp.34-38
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• 2020

Recently, various lasers and energy-based devices (EBDs) have been widely used in aesthetic procedures. Although using lasers and energy-based aesthetic procedures presents a potential risk to doctors, nurses, and patients, aesthetic procedures tend to be performed without the necessary precautions. For injury prevention, it is essential to follow safety rules and be aware of potential accidents. Furthermore, it is important to understand the basic principles of the devices, including the different optical and electrical properties. Acquiring the exact knowledge to control a device is important for two reasons; to maintain a safer operating environment and prolong the lifespan of expensive devices. This review briefly summarizes the knowledge needed for better and safer aesthetic procedures and the proper control of aesthetic devices.

• The Korean Journal of Emergency Medical Services
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• v.26 no.2
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• pp.87-96
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• 2022

Purpose: By analyzing the health status of emergency patients on islands in the Jeollanam-do province, this study aims to provide basic data for proposed future medical emergency services on the islands. This information includes monthly and hourly statistics on patients' characteristics, patient frequency, an analysis of first aid procedures, response times, and time spent at hospitals. Methods: The study analyzed the monthly and hourly frequency of emergency patients, first aid status and procedures, general patient characteristics, accident types, patient cognitive status and agility, marine police response times, and frequency and percentile of hospital dispatch times. Results: 1Q and #q show the highest patient turnover rate in one year. 50.5% of daily patients are admitted between 4 PM and 12 PM. The hospital dispatch time is within a one- to two-hour window for 54.0% of all patients. Conclusion: The emergency medical service system for the Jeollanam-do province islands and seas is available to all Korean residents, citizens, and visitors. It is necessary to implement an emergency medical system for the relevant organizations.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.205-210
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• 2023

Left coronary artery divides into anterior interventricular branch and circumflex branch. As both the arteries run in their corresponding grooves, an arteriovenous trigone is formed between conus arteriosus and left auricle called triangle of Brocq and Mouchet. The triangle base is formed by great cardiac vein. This study aims to describe the frequency of triangle and its type and relationship between various boundaries and content of triangle and to supplement the existing knowledge of clinicians. This observational and descriptive study was conducted on 40 formalin fixed cadaveric hearts in department of anatomy, Kalpana chawla government medical college. The triangle was found in 92.5% of specimen with most common type being closed (51.3%) which is followed by inferiorly open in 35.1%, superiorly open in 8.1% and completely open in 5.4% hearts. Most frequent content of triangle was median artery followed by diagonal branches of anterior interventricular and circumflex branches. The mean area of the triangle was 246.3 mm². Relationship of vein with two arterial branches was either superficial or deep. The knowledge of different patterns of existence will be required for angiographic procedures. Further the triangle is a potential epicardial access route to left fibrous ring. Thus detailed knowledge of variations will help cardiologist to achieve better outcome in interventional procedures with minimal complications.

• Nuclear Engineering and Technology
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• v.56 no.1
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• pp.335-339
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• 2024

Employees of nuclear medicine facilities performing medical procedures with the use of open radioactive sources require continuous detailed control of exposure to ionizing radiation. Thermoluminescent (TL) detectors placed in dosimeters: for the whole body, for lenses, ring and wrist dosimeters were used to assess exposure. The highest whole-body exposure of (1.70 ± 1.09) µSv/GBq was recorded in nurses administering radiopharmaceutical to patients. The highest exposure to lenses and fingers was recorded for employees of the quality control zone and it was (8.08 ± 2.84) µSv/GBq and a maximum of (1261.46 ± 338.93) µSv/GBq, respectively. Workers in the production zone received the highest doses on their hands, i.e. (175.67 ± 13.25) µSv/GBq. The measurements performed showed that the analyzed workers may be classified as exposure category A. Wrist dosimeters are not recommended for use in isotope laboratories due to underestimation of ionizing radiation doses. Appropriately selected shields, which significantly reduce the dose received by employees, must be used in isotope laboratories. Periodic measurements confirmed that the appropriate optimization of exposure reduces the radiation doses received by employees.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.323-327
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• 2024

This case report presents 2 patients with gastroesophageal junction cancer who both underwent totally minimally invasive esophagectomy with colon interposition. Patients 1 and 2, who were 43-year-old and 78-year-old men, respectively, had distinct clinical presentations and medical histories. Patient 1 underwent minimally invasive robotic esophagectomy with a laparoscopic total gastrectomy, colonic conduit preparation, and intrathoracic esophago-colono-jejunostomy. Patient 2 underwent completely robotic total gastrectomy, colon conduit preparation, and intrathoracic esophago-colono-jejunostomy. The primary challenge in colon interposition is assessing colon vascularity and ensuring an adequate conduit length, which is critical for successful anastomosis. In both cases, we used indocyanine green fluorescence angiography to evaluate vascularity. Determining the appropriate conduit is challenging; therefore, it is crucial to ensure a slightly longer conduit during reconstruction. Because totally minimally invasive colon interposition can reduce postoperative pain and enhance recovery, this surgical technique is feasible and beneficial.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.169-208
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• 2016

"Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)" has been enacted to solve medical dispute. In addition, mediation and arbitration procedures have started since April 8th, 2012 from the Establishment of Korea Medical Dispute Mediation and Arbitration Agency. The average initiation rate of mediation for the past three years turned out to be 43%. Hereupon, Establishment of Korea Medical Dispute Mediation and Arbitration Agency has created a solution for automatic initiation if relevant to particular conditions to improve initiation rate of mediation procedures and passed it through the Assembly plenary session in May, 2016 and promulgated on the 30th of the same month. However, even if mediation procedure initiation rate is increased, there is no guarantee for mediation establishment rate to be improved according to current law. If Establishment of Korea Medical Dispute Mediation and Arbitration Agency intends to increase aforementioned value, automatic initiation is not the only solution. Instead, it seems to be a major assignment to identify fundamental reasons for why major health care facilities have not participated in it and to restore reliability on them. In addition, among crimes specified on the Article 268 of Criminal Act in the Article $51^*$ of "Act on Remedies for Injuries from Medical Malpractive and Mediation of Medical Disputes)", revision must be made so that the clause of clue and death by occupational or gross negligence is applied. Furthremore, it is suggested to supplement previously insufficient policies with the operation so that mediation procedures created by Establishment of Korea Medical Dispute Mediation and Arbitration Agency are stably settled in the perspective of medical institutions including the establishment of new conditions for medical institutions founders or health and medical service personnel to claim the proxy payment for damage.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.545-554
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• 2021

According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.121-124
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• 2023

With the continuous incorporation of new technologies and advancements in surgical technique, microsurgical procedures around the world have generated a higher success rate and innovative procedures are now possible. In this setting, limitations regarding accessibility and acquisition of medical resources and equipment for these types of operations may be difficult in developing countries. We believe the dexterities of surgeons go beyond the surgical technique, meaning that we are able to use everyday materials to re-create affordable solutions that can be used during surgery in a safe way. This manuscript presents our experience with different surgical instruments and gadgets, developed out of necessity, to improve microsurgical interventions in developing countries.

• Journal of the Korean Institute of Rural Architecture
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• v.26 no.2
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• pp.73-84
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• 2024

This study investigated the outpatient departments of Infectious Disease Hospitals by Region, which play an important role in establishing regional medical networking, to find a spatial structure that can provide a safe environment for efficient diagnosis and treatment, as well as a rational medical procedure in case of crisis. Department layout and adjacencies were derived by considering the access procedures according to patient classification, medical procedures by department, and connectivity with other departments. Based on the results derived by setting up zones according to infection control, activities, and objects, and analyzing the division of zones, the composition of areas by activities, movement flows by objects and treatment units, it can be used as basic data for the architectural plan of the Infectious Disease Hospital. Also, there are implications that can be used as basic data for planning related facilities by analyzing spatial relationships according to user behavior.