• Transactions on Electrical and Electronic Materials
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• v.5 no.4
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• pp.133-137
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• 2004

The development of digital x-ray detector has been extensively progressed for the application of various medical modalities. In this study, we introduce a new hybrid-type x-ray detector to improve problems of a conventional direct or indirect digital x-ray image technology, which composed of multi-layer structure using a CaWO$_4$ phosphor and amorphous selenium (a-Se) photoconductor. The leakage current of our detector was found to be ∼180 pA/cm$^2$ at 10 V/m, which was significantly reduced than that of a single a-Se detector. The x-ray sensitivity was measured as the value of 4230 pC/cm$^2$/mR at 10 V/m. We found that the parylene thin film between a CaWO$_4$ phosphor and an a-Se layer acts as an insulator to prevent charge injection from indium thin oxide (ITO) electrode into an a-Se layer under applied bias.

• Journal of the Korean Physical Therapy Association
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• v.13 no.1
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• pp.5-17
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• 1992

Depression in Spinal Cord Injury Patients Kang, Soon Hee, M.Ed., R.P.T. Dept. of Rehabilitation Medicine, Kyung-Hee University Medical Center Depressions have the potential to affect adversely the rehabilitation of patients with spi-nal cord iniury. The present study examined depression, functional independence, and demographic and medical characteristics for 49 spinal cord injury(SCI) patients. This investigation involved the administration of the Beck Depression Inventory, the Modified Barthel Index, and aquestionnaire consisted of 14 items, The results were as follows .1. Compared to normal subjects, SCI patients had significantly higher BDI scores.2. When the cut-off point of HDI scores was assumed 21, 26.1% of normal subjeets and 75.5% of SCI patients appeared to be depressed. Depression in SCT patients were not related with age, sex, marital status, injury evel, severity, duration, pain, functional independence and medical charge. Depression in SCI patients were related with education level, economic level, age at injury, motivation. Depression in normal subjects were related with age, education level, economic level, but not related with sex, marital status. There were significant differences at 30 items of BDI between normal subjects and SCI patients. The items were as fellows . 1 sadness, 2 pessimism, 3 failure, 4 dissat-isfaction, 5 guilt, 6 punishment. 7 self-dislike 9 suicidal, 10 crying, 11 irritability, 12withdrawl, 13 indecisive, 14 self-image, IS work inhibition, 16 insomnia, 17 fatigue,18 anorexia, 19 weight loss, 20 hypochondria, 21 libido loss.

• Journal of Biomedical Engineering Research
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• v.34 no.1
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• pp.34-39
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• 2013

For the biocompatibility test of implantable devices or for the sensitivity evaluation of biomedical sensors, it is required to understand the mechanism of the protein adsorption and the interaction between the adsorbed proteins and cells. In this study, the adsorption of proteins in a cell culture medium with fetal bovine serum onto an indium tin-oxide electrode was characterized by using linear sweep voltammetry and impedance spectroscopy. We immersed the fabricated ITO electrodes in the culture medium for 30, 60, or 90 min, and then measured the electrochemical properties of electrodes with 10 mM $Fe(CN){_6}^{3-/4-}$ and 0.1 M KCl electrolyte. With an increase of contacting time, the anodic peak current was decreased and the charge transfer resistance was increased. However, both parameters were recovered to the values before contact with the medium after the treatment of Trypsin/Ethylenediaminetetraacetic acid hydrolyzing proteins.

• Health Policy and Management
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• v.7 no.2
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• pp.109-146
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• 1997

This study explores the feasibility of activating private health insurance in Korea. The rationale for expanding private supplementary health insurance can be found in many cases of health care reforms in the European countries. Private health insurance can not only relieve the financial distress of the government health insurance programs but also offer the medical institutions incentives to improve the quality of medical care. In Korea there is no supplementary health insurance that reimburses for various kinds of diseases based on a well designed fee schedule. Recently, the cancer insurance is the best seller in the health related insurance market. As observed in the U. S. case, the cancer insurance which pays the predetermined amount (indemnity coverage) regardless of the medical charges incurred to the patient is limited in its coverage for the insured. To provide better protection against catastrophic diseases, the government should give insurance companies incentives to develop health insurance products that cover multiple diseases rather than a single disease. Consumers can hardly understand and compare complex insurance products. To resolve the information asymmetries, the government should publish a consumer report that compare various health insurance products in a user friendly way. In the long run, insurance companies will plan to sell health insurance products that charge risk related premium only when insurers accumulate the underwriting know-hows, the government shares data on various health statistics including claims and demographics, and risk pool for high risk patients is well established and subsidized by the government.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.156-161
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• 2018

Objectives: To evaluate results and workloads of the horizon scanning of the emerging health technology since 2014 to 2016. Methods: In order to analyze the results of the emerging health technology, we identified the number of research procedure between 2014 and 2016. The sixteen findings were calculated annual workload by person, and categorized by medical phase, classification of disease, and healthcare technology. Results: An average of 5.67 personnel were involved over three years, assessment of each emerging healthcare technology was performed for each person of identifying 54 cases, filtering 2.4 cases, prioritizing 0.9 cases were performed. According to the mapping by healthcare technologies, nine medical devices (56.3%), six drugs (37.5%), and one material of the medical treatment (6.3%) were assessed. Among sixteen findings, fifteen cases were health technologies for treatment and only one case for diagnosis. Conclusion: Future plans of the horizon scanning of the emerging health technology is required appropriate manpower in charge each target number of assessment. And a legal basis should be provided for policy reflection rate. Furthermore, an evaluation criteria and procedures should be transparent to avoid a conflict of interest.

• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Progress in Medical Physics
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• v.15 no.2
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• pp.105-111
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• 2004

The parallel plate detector with dielectric film for dosimetry was designed to measure detection characteristic of 6 MV X-ray with medical linear accelerator. PTFE film was inserted into FEP films that are made by two one-side metal coated materials for ion source. The thicknesses of PTFE dielectric film was 100 ${\mu}{\textrm}{m}$ and the thickness of FEP dielectric film was 100 ${\mu}{\textrm}{m}$, respectively. This detector was fixed by two acrylic plate for physical hardness ad geometrical consistency. The geometrical condition for measurement with parallel-plate for detector was below; SSD=100 cm and the 5 cm depth between detector and phantom surface The major parameter of detector characteristics such as zero drift current, leakage current, charge response by applied voltage, reproducibility, linearity, TMR measurement, dose rate effect were measured. The zero drift currents are 8.3 pA and leakage currents are 10 pA. The charge response of applied voltage is showing linearity in 414 voltage. The measurement deviation of reproducibility in this detector is within 1% for dose and the linearity of applied dose shows in this detector. The TMR curves in phantom between this parallel plate detector and reference detector are matched within 3% deviation from maximum dose depth to 7.5 cm depth. It is considered that this dosimetric system is satisfactory for the purpose of the constancy check of the 6 MV x-ray from medical linear accelerator.

• Journal of Genetic Medicine
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• v.6 no.1
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• pp.38-55
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• 2009

Purpose: This study was undertaken to provide the framework for development of a genetic counseling training program, and an accreditation and certification process suitable for non-M.D. genetic counselors in Korea. Materials and Methods: Global standards of genetic counseling curriculums, training program accreditation (TPA), and the certification process for genetic counselors (CPGC) in the U.S.A and Japan were reviewed, and a questionnaire survey was performed to elicit opinions among health-care providers including physicians, nurses, technicians, researchers, and educators. In addition, input from professional communities, including the Korean Society of Medical Genetics (KSMG) and Institute for Genetic Testing Evaluation, was sought in formulating the framework of this study. Results: Comparison of U.S.A. and Japan educational systems showed similarities in curriculum, accreditation, and certification programs. Analysis of 117 respondents opinions showed a high level of agreement in the area of global standards; 88% indicated that KSMG should be in charge of TPA and CPGC, while 77% favored a certification exam composed of both written exam and interview components. Conclusion: Based upon this study we propose that the KSMG should be in charge of providing the TPA and CPGC for non-MD genetic counselors. Requirements for the entrance to a Master's degree genetic counseling program should be open to successful four year undergraduate students in all areas, provided the candidates demonstrate the abilities to master the graduate level of study in human genetics, clinical genetics, statistics, psychology, and other required subjects. Eligibility for certification should include qualified candidates of genetic counseling with no formally approved education, but a sufficient amount of clinical experience, in addition to accredited program graduates. Certification examinations should be carried out every two years and the certification should be good for five years, as is the case in Japan.

• Journal of muscle and joint health
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• v.3 no.2
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• pp.166-176
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• 1996

This is a study through survey with the purpose of analysing of treatment cost for arthritis. Treatment cost can be devided Into two characteristics, one is the direct cost and the other is the indirect cost. Direct cost contains fees of medical treatment Including cost of self treatment & purchsing price of herb durg. On the other hand indirect cost means the using money of tansportation, lodging charge & labor-losing-time cost. For the succession of medical treatment of chronic diseases patients have to control themselves to go shopping around for the cure remeadies. And also it is important that the cost for unefficient or probably hamful folk remeadies should be reduced in order to distribute appropriatively the limited financial resources. As the result of this study, the fees for self treatment & herb drug are two times as much as those of regural medical treatment. Within the direct cost, there are the mean cost of regural medical treatment 59,630 won/mon., self-treatment 42,790 won/mon., and herb drug 78,380won/mon. therefore total mean direct cost is 180,800won per month. Moreover patients intermittently pay the cost of prostheses If folk remedies, these are added to the direct cost as above mentioned. Attributes of folk remedies are various from cure & analgesics to nutrients and their virtues as medicine are not clear in view of scientific knowledge. But 56% of arthritis patients have ever been experienced folk remedies. the cost for these remedies has wide ranges from 40,000 won to 1,000,000won. Total mean indirect cost including the transfortation fee, lodging charge & labor-losing-time cost has the range from 82,825won/month to 106,150won/month. Among these cost, labor-losing-time cost has a mojority because the waiting times are too long for seeing a doctor. In conclusion those patients having arthritis have a large burden against the treatment cost for continuous care. Therefore health professional should make effort to guide the patient to determine themselves informed choice about the treatment process.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.110-118
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• 1994

As the first step to improve the medical recording for the hospitalized patients, we tried to identify problems of completion rate of the medical recording and made the completion rate of the medical recording within due date known to the public in the hospital and commended the best Department and resident officially. The results were as follows: 1. The average number of the medical recordings per a recorder by years of residency(average number to quorum) was 293.3(398.8) in 1st year, 82.5(68.1) in 2nd year, 21.2(8.3) in 3rd year, and 20.5(1.9) in 4th year-residents. There was only 2 residents who prepared the medical recordings more than the average of 125.6 recordings per a resident. 2. Among 13 Departments, the medical recording was wholly put in charge of the 1st year-resident in 6 Departments. The duty was shared with the 2nd year-resident in 5 Departments and the 3rd year-resident in 1 and the 4th year-resident in Only 1 Department. 3. The more the cases requiring the medical recording, the lower the completion rate(80% less than 100 recordings, 70% in 100-299, 60% in 300-399 and 33.3% in more than 400). 4. There was no difference in the completion rate of the medical recording before(1991) and after(1993) a public nitice(1992). However, 4 Departments showed improvement of 21-45% in the completion rate, and no case was found where billing for medical assurance was postponed due to delayed completion of the medical recording. 5. The completion rate was relatively low(72-78%) from January to March. The main reasons were shortage of men power due to preparation of board examination, attendance to military duty, and lack of training in the medical recording for the new 1st year-residents. 6. The official commendation of the best Department and resident by letters did not improve the completion rate of the medical recording. In conclusion, The main reason of the low completion rate of the medical recording was the fact that the 1st year-residents were almost exclusively responsible for the medical recording. Hence, it is mandotory that this practice gets staffs' attention to improve the completion rate. Public notice of the completion rate of the medical recording shows prompt improvement of the completion rate. Prize money rather than commendation by a letter for the best Department would also be more effective to improve the quality of medical recording.