• Title/Summary/Keyword: Medical charge

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The development of Fetal Heart Rate monitoring system based on DSP processor (DSP 프로세서를 이용한 태아심음 및 자궁수축감시장치의 개발)

  • Jnag, D.P.;Kim, K.H.;Lee, Y.H.;Lee, Y.K.;Bak, M.I.;Lee, D.S.;Kim, S.I.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.320-324
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    • 1996
  • Digital fetal monitoring system based on the personal computer combined with the digital signal processing board was implemented. The DSP board acquires and digitally processes ultrasound fetal Doppler signal for digital rectification, FIR filtering, autocorrelation function calculation, its peak detection and MEDIAN filtering. The personal computer interfaced with the DSP board is in charge of graphic display, hardcopy, data transmission and on-line analysis of fetal heart rate change including and variability. I used a recursive technique for autocorrelation function computation method and MEDIAN filter which can greatly reduce the amount of calculation and accuracy. I also implemented analysis algorithm of fetal heart rate change based on normal fetal sample data in order to exact diagnosis.

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A Study on Factors for Improving CPR based on Health Care Professionals Treating Cardiac Arrests

  • Bae, Soo Jin;Hong, Sun Yeun
    • International Journal of Internet, Broadcasting and Communication
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    • v.13 no.1
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    • pp.229-237
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    • 2021
  • This study aimed to help build a quality control program to improve cardiac arrest treatment via analysis of medical records in a local tertiary general hospital to evaluate factors that influence clinical outcomes of in-hospital cardiac arrest. At first, the medical records of in-hospital cardiac arrest were analyzed, and targeted surveys about functional and structural factors associated with cardiopulmonary resuscitation (CPR) were conducted amongst the workforce in charge of cardiac arrest treatment. From January 2012 through June 2013, a total of 486 adult cases of in-hospital cardiac arrests, except for those occurring in the emergency room, were enrolled in this study. Among the patients, those of recovery of spontaneous circulation were 57.8%; 13.8% of patients were discharged alive; 8.9% of patients were discharged without significant neurologic sequela. Despite CPR is usually successful when administered as quickly as possible, in this analysis showed that prompt reaction after initial recognition was significantly lower in nurses compared with doctors. Analysis of survey results showed that confidence in performing CPR was significantly associated with the experience of CPR in doctors, while in nurses educational experience showed a correlation. In order to improve quality of in-hospital CPR system maintaining and increasing confidence of CPR performance is the most important factor. Therefore it can be helpful to develop and apply a phased, customized education program using training simulators as well as personalizing them to increase the personnel's confidence in CPR performance.

A study on enhancing professionalism of civil anti-disaster organizations for public safety in Korea: with a focus on CAIND (한국 재난관리 체계에서 민간 방재조직의 전문성 제고 방안 - 지역자율방재단을 중심으로 -)

  • Chae, Jong-Sik
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.163-178
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    • 2021
  • Purpose: This study explored a plan for improving the overall preventive activity of Korean Citizen-Corps-Active-in-Disaster (CAIND). Methods: The study used the documentary survey and the technical approach methods. This way, detailed information regarding civil anti-disaster organizations was found in scholarly monographs, specialty publications, and master's/doctoral dissertations. It further utilized the statistical yearbooks between 2015 and 2018 from the Korean Ministry of Public Administration, Security, and Fire Service, and the National Statistical Office, to discover practical problems through a statistical analysis. Volunteer activities being inherent, related issues were reviewed at the same time to for purposes of clarifying the characteristics of disaster prevention activity by CAIND. Results: The study provided four major suggestions for improvement. First, the quota management system of Korean CAIND considering the characteristics of rural areas should be supplemented. Second, the education and training systems of Korean CAIND should be established to satisfy regional conditions. Third, management members' readership competency in operating organizations, including that of the Korean CAIND captain in charge, should be strengthened. Fourth, the reward system for Korean CAIND activities should be improved. Conclusion: In the future, the results of this study are expected to be utilized as a basic data to develop Korean CAIND.

The Importance of Strengthening the Role of the Institutional Review Board and the Human Research Protections Program following the Revision of the Act on the Safety and Support of Advanced Regenerative Medicine and Advanced Biopharmaceuticals ('첨단재생의료 및 첨단바이오의약품 안전 및 지원에 관한 법률' 개정에 따른 '기관생명윤리위원회(Institutional Review Board)' 역할 및 '임상시험 및 대상자보호프로그램(Human Research Protections Program)' 강화의 중요성)

  • Byung Soo Kim
    • The Journal of KAIRB
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    • v.6 no.1
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    • pp.1-4
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    • 2024
  • The strengthening of Institutional Review Board (IRB) and Human Research Protection Program (HRPP) for clinical research on advanced regenerative medicine reflecting the 3 Principles of the Belmont Report (Respect, Beneficence, Justice) is very important. The research institution IRB should naturally be in charge of managing the clinical research process. And it is crucial to reinforce HRPP for the protection of research subjects in institutions conducting advanced regeneration clinical research. So, it is needed to establish a Protection System for Advanced Regenerative Medical Research Subjects composed of clinical research management communication system for advanced regenerative medicine between KAIRB (Korean Association of IRB) of research institutes and National Management Agency for Advanced Regenerative Medical Research. In advanced regenerative medicine clinical research to verify safety and efficacy of the investigational drugs to the subjects with rare and incurable diseases rather than to treat the patients, it is hoped that a management system that guarantees the scientific characteristics of research and the rights of research subjects would be well organized and operated.

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Role of $Ca^{2+}$ for Inactivation of N-type Calcium Current in Rat Sympathetic Neurons (흰쥐 교감신경 뉴론 N형 칼슘전류의 비활성화에 미치는 칼슘효과)

  • Goo, Yong-Sook;Keith S. Elmslie
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.54-67
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    • 2003
  • The voltage-dependence of N-type calcium current inactivation is U-shaped with the degree of inactivation roughly mirroring inward current. This voltage-dependence has been reported to result from a purely voltage-dependent mechanism. However, $Ca^{2+}$-dependent inactivation of N-channels has also been reported. We have investigated the role of $Ca^{2+}$ in N-channel inactivation by comparing the effects of $Ba^{2+}$and $Ca^{2+}$ on whole-cell N-current in rat superior cervical ganglion neurons. For individual cells in-activation was always larger in $Ca^{2+}$ than in $Ba^{2+}$ even when internal EGTA (11 mM) was replaced with BAPTA (20 mM). The inactivation vs. voltage relationship was U-shaped in both divalent cations. The enhancement of inactivation by $Ca^{2+}$ was inversely related with the magnitude of inactivation in $Ba^{2+}$ as if the mechanisms of inactivation were the same in both $Ba^{2+}$ and $Ca^{2+}$. In support of this idea we could separate fast ( ${\gamma}$ ~150 ms) and slow ( ${\gamma}$ ~ 2500 ms) components of inactivation in both $Ba^{2+}$and $Ca^{2+}$ using 5 sec voltage steps. Differential effects were observed on each component with $Ca^{2+}$ enhancing the magnitude of the fast component and the speed of the slow component. The larger amplitude of fast component indicates that the more channels inactivate via this pathway with $Ca^{2+}$ than with $Ba^{2+}$, but the stable time constants support the idea the fast inactivation mechanism is identical in $Ba^{2+}$and $Ca^{2+}$. The results do not support a $Ca^{2+}$-dependent mechanism for fast inactivation. However, the $Ca^{2+}$-induced acceleration of the slowly inactivating component could result from a $Ca^{2+}$-dependent process.

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Veterans Hospital Medical Expenses Increase & Decrease Characteristics and Convergence Phenomenon-Focusing on the implications of the medical support system for national veterans-

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • v.9 no.1
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    • pp.16-21
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    • 2021
  • As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

Impact of Coronavirus Disease 2019 on Gastric Cancer Diagnosis and Stage: A Single-Institute Study in South Korea

  • Moonki Hong;Mingee Choi;JiHyun Lee;Kyoo Hyun Kim;Hyunwook Kim;Choong-Kun Lee;Hyo Song Kim;Sun Young Rha;Gyu Young Pih;Yoon Jin Choi;Da Hyun Jung;Jun Chul Park;Sung Kwan Shin;Sang Kil Lee;Yong Chan Lee;Minah Cho;Yoo Min Kim;Hyoung-Il Kim;Jae-Ho Cheong;Woo Jin Hyung;Jaeyong Shin;Minkyu Jung
    • Journal of Gastric Cancer
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    • v.23 no.4
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    • pp.574-583
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    • 2023
  • Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide. National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the "before COVID" period, and the years 2020 and 2021 as the "during COVID" period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it. Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions: During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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A Study on the Activation·Specification of 119 Rescue & Care in JeJu (제주도 119구조·구급대의 활성화 및 전문화 방안)

  • Koh, Jae-Moon;Kim, Tae-Min;Kim, Hyo-Sik;Lee, Young-A
    • The Korean Journal of Emergency Medical Services
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    • v.6 no.1
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    • pp.153-168
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    • 2002
  • Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

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