• Title/Summary/Keyword: Medical organization

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A study on the Six-surface theory in Shang-Han-Lun - Focussed on the Ke-qin's Shang-Han-Lun-Yi - ("상한론(傷寒論)" 육경지면설(六經地面說)에 관한 연구(硏究))

  • Lee, Sang-Hyup
    • Journal of Korean Medical classics
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    • v.26 no.3
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    • pp.33-52
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    • 2013
  • Objective : Zhang Zhong-jing's Shang-Han-Lun is based on Six-channels system(六經) to classified a disease, but the notion of this seems to be a very various angles. Among them, Ke-qin(柯琴)'s Six-surface theory(六經地面說) is very clearly explained the notion of Six-channels system(六經) and it provide crucial clue to understanding a Shang-Han-Lun Method : I will try to describe the Six-surface theory(六經地面說) through the Ke-qin's Shang-Han-Lun-Yi(傷寒論翼). At the core of this paper, The diaphragm is the most important criterion to understand a Six-channels system(六經), and it is based on the human body to divided into Yin-Yang(陰陽). Result : Ke-qin's Six-surface theory(六經地面說) is connected with Meridian system(經絡), Viscera and Bowels(臟腑), and their functions. It is the concept of comprehensive to including those related were grouped into the surface. Conclusion : Six-surface(六經地面) is far beyond the simple concept of Meridian, and it include organization of pathology concepts carrying up to what happens on the human body caused by disease. We can see that Zhong-jing's(仲景) medical treatment from syndrome differentiation(辨證) is associated with a holism(整體觀).

Concept and Development of Resident Training Program for General Competencies (전공의 공통역량의 개념과 개발)

  • Lee, Sun Woo
    • Korean Medical Education Review
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    • v.19 no.2
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    • pp.63-69
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    • 2017
  • Resident training programs in South Korea lag far behind that of advanced countries. Given the problems the current system in South Korea has, it is time to consider a new resident training system, resident training for general competencies. Training for the general competencies was practiced in medical fields in advanced countries such as the USA, Canada, and the UK as early as 20 years ago. This system has rendered itself a key component of resident training. Although a few theoretical procedures on general competencies have been practiced in South Korea, the awareness of this concept is still very weak, and the application of the theory to actual training is a long way off from becoming effective. It is urgent for South Korea to adopt competency- and outcome-based training for general competencies. To this end, the knowledge of the concept of this type of training should be improved. Also, the system should be carefully designed to cover a doctor's whole career, and be applied immediately. The competency- and outcome-based training for general competencies is a system that assures high level qualifications. It reflects the needs of our society under the recognition that a professional organization should be committed and accountable in order to respond to social demands. As the benefits of the new training system reach the public and medical care consumers, training-related expenses should be borne by social costs.

The Synaptic Organization of the Cat Striatum (고양이 선조체의 신경연접기구에 대한 형태학적 관찰)

  • Chung Jin-Woong;Choi Wol-Bong;Kwun Hung-Sik
    • Applied Microscopy
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    • v.8 no.1
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    • pp.53-66
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    • 1978
  • An attempt has been made to discriminate the synapses in the striatum consisting caudate nucleus, putamen and fundus striati of the cat with emphasis on the characteristic structures of axon terminals and postsynaptic profiles. The differentiation is based on the size and shape of vesicle in the bouton terminal, and the symmetrical or asymmetrical thickening the pre- and postsynaptic membrane. Four types of synapses could be differentiated: Type I: the bontons with asymmetrical,synaptic thickenings contain round 45 nm diameter vesicles and contact cell soma, dendritic shafts and dendritic spines (74%). Type II : the boutons contain round 45nm diameter vesicles and are associated with symmetrical membrane thickenings. These synapses are formed on the soma and dendritic shafts (6%). Type III: the boutons with symmetrical membrane thickenings contain 50-60 nm diameter pleomorphic vesicles, and contact soma and dendritic shafts (18%). Type IV: the terminals contain flattened vesicles ($25{\times}45 nm$) and are associated with symmetrical membrane thickenings. These synapses are found in contact with soma and dendritic shafts. Additionally, the bouton en passant, which is expanded from myelinated or unmyelinated axons containing round vesicles (45nm diameter) contacts the dendritic shaft or dendritic spine with asymmetrical membrane thickenings. Two unusual types of synapses, axo-axonic and dendro-dendritic, are found occasionally.

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Characterization of Single Nucleotide Polymorphisms in 55 Disease-Associated Genes in a Korean Population

  • Lee, Seung-Ku;Kim, Hyoun-Geun;Kang, Jason-J.;Oh, Won-Il;Oh, Berm-Seok;Kwack, Kyu-Bum
    • Genomics & Informatics
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    • v.5 no.4
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    • pp.152-160
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    • 2007
  • Most common diseases are caused by multiple genetic and environmental factors. Among the genetic factors, single nucleotide polymorphisms (SNPs) are common DNA sequence variations in individuals and can serve as important genetic markers. Recently, investigations of gene-based and whole genome-based SNPs have been applied to association studies for marker discovery. However, SNPs are so population-specific that the association needs to be verified. Fifty-five genes and 384 SNPs were selected based on association with disease. Genotypes of 337 SNPs in candidate genes were determined using Illumina Sentrix Array Matrix (SAM) chips by an allele-specific extension method in 364 unrelated Korean individuals. Allelic frequencies of SNPs were compared with those of other populations obtained from the International HapMap database. Minor allele frequencies, linkage disequilibrium blocks, tagSNPs, and haplotypes of functional candidate SNPs in 55 genetic disease-associated genes were provided. Our data may provide useful information for the selection of genetic markers for gene-based genetic disease-association studies of the Korean population.

Has Income-related Inequity in Health Care Utilization and Expenditures Been Improved? Evidence From the Korean National Health and Nutrition Examination Survey of 2005 and 2010

  • Kim, Eunkyoung;Kwon, Soonman;Xu, Ke
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.5
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    • pp.237-248
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    • 2013
  • Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

A Study of Digital Image Analysis of Chromatin Texture for Discrimination of Thyroid Neoplastic Cells (갑상선 종양세포 식별을 위한 염색질 텍스춰의 디지탈 화상해석에 관한 연구)

  • Juhng, Sang-Woo;Lee, Jae-Hyuk;Bum, Eun-Kyung;Kim, Chang-Won
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.23-30
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    • 1996
  • Chromatin texture, which partly reflects nuclear organization, is evolving as an important parameter indicating cell activation or transformation. In this study, chromatin pattern was evaluated by image analysis of the electron micrographs of follicular and papillary carcinoma cells of the thyroid gland and tested for discrimination of the two neoplasms. Digital grey images were converted from the electron micrographs, nuclear images, excluding nucleolus and intranuclear cytoplasmic inclusions, were obtained by segmentation; grey levels were standardized; and grey level histograms were generated. The histograms in follicular carcinoma showed Gaussian or near-Gaussian distribution and had a single peak, whereas those in papillary carcinoma had two peaks(bimodal), one at the black zone and the other at the white zone. In papillary carcinoma, the peak in the black zone represented an increased amount of heterochromatin particles and that at the white zone represented decreased electron density of euchromatin or nuclear matrix. These results indicate that the nuclei of follicular and papillary carcinoma cells differ in their chromatin pattern and the difference may be due to decondensed chromatin and/or matrix substances.

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Root cause analys is and improving strategy of suicidal sentinel events (의료기관 내 자살사건의 근본원인분석과 개선전략)

  • Lim, Hun-Sun;Kim, Hong-Soon;Yum, Ho-Kee
    • Quality Improvement in Health Care
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    • v.19 no.2
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    • pp.50-64
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    • 2013
  • Objectives : Suicide is a serious sentinel event in healthcare organization. Suicide and suicidal attempt are fatal and long lasting mental and physical damage to themselves, family, and medical staffs. To develope the system to prevent suicidal accident in hospital, we reviewed and analysed one case of suicidal sentinel event. Methods: The risks of suicidal sentinel event were evaluated and analysed through the root cause analysis and failure mode effects analysis. Result: We found several root causes such as initial assessment of oldest patient and security issues. Couple of action plans to fix the problems were done immediately. According to failure mode, we evaluate the risk priority number to modify the action plans. Conclusion: To reduce the risk of sentinel events, we reviewed the suicidal event and established the new system and action plan to prevent sentinel events.

Influence of Types of Leadership and Organizational Culture on Innovative Behavior of Professional Staff of a General Hospital (리더십유형과 조직문화가 종합병원 구성원의 혁신행동에 미치는 영향)

  • Kim, Hyun Suk;Kang, Kyeong Hwa
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.4
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    • pp.447-456
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    • 2015
  • Purpose: The purpose of the study was to identify factors affecting the innovative behavior of general hospital professional staff. Methods: In the final analysis, the study focuses on the 442 structured questionnaires received from the professional staff (doctors, nurses, medical technicians, and administrative staff) of H Hospital, a public medical foundation. Data were collected from August 1 to 31, 2014. The SPSS/WIN 19.0 program was used for data analysis which included t-test, ANOVA, $Scheff\acute{e}$ test, Pearson correlation coefficients, and multiple regression analysis. Results: Multiple regression showed that factors affecting innovative behavior of hospital professional staff were conditional reward, innovation-oriented culture, education, and job (Adj $R^2=.317$). Conclusion: The results of this study suggest that it is necessary for the leader to demonstrate leadership with innovation and transaction in harmony to cultivate innovative behavior in hospital staff. Also, positive support and role in the hospital organization are fundamental to developing the strengths that each type of culture possess on the basis of the organizational culture of hospital, enabling hospital staff to exhibit their best voluntary innovative behavior.

Genetic Risk Prediction for Normal-Karyotype Acute Myeloid Leukemia Using Whole-Exome Sequencing

  • Heo, Seong Gu;Hong, Eun Pyo;Park, Ji Wan
    • Genomics & Informatics
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    • v.11 no.1
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    • pp.46-51
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    • 2013
  • Normal-karyotype acute myeloid leukemia (NK-AML) is a highly malignant and cytogenetically heterogeneous hematologic cancer. We searched for somatic mutations from 10 pairs of tumor and normal cells by using a highly efficient and reliable analysis workflow for whole-exome sequencing data and performed association tests between the NK-AML and somatic mutations. We identified 21 nonsynonymous single nucleotide variants (SNVs) located in a coding region of 18 genes. Among them, the SNVs of three leukemia-related genes (MUC4, CNTNAP2, and GNAS) reported in previous studies were replicated in this study. We conducted stepwise genetic risk score (GRS) models composed of the NK-AML susceptible variants and evaluated the prediction accuracy of each GRS model by computing the area under the receiver operating characteristic curve (AUC). The GRS model that was composed of five SNVs (rs75156964, rs56213454, rs6604516, rs10888338, and rs2443878) showed 100% prediction accuracy, and the combined effect of the three reported genes was validated in the current study (AUC, 0.98; 95% confidence interval, 0.92 to 1.00). Further study with large sample sizes is warranted to validate the combined effect of these somatic point mutations, and the discovery of novel markers may provide an opportunity to develop novel diagnostic and therapeutic targets for NK-AML.

Research Trend Analysis on Job Stress of Hospital Nurses (병원 간호사의 직무스트레스에 관한 연구 동향 분석)

  • Oh, EunYoung;Kang, KyongHwa;Kim, KwangJum;Min, HeungKi
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.16-27
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    • 2018
  • 1) Purpose : The purpose of this research is to identify the trend of job stress of hospital nurses based on last 10 years of domestic research and to suggest directions for systematic future research. 2) Methodology : 101 studies between 2006 and 2016 were selected using key words such as registered nurse and job stress from Academic Information Service(Riss4u), the National Assembly Library and Korean studies Information Service System(KISS). 3) Findings : The researches on job stress of hospital nurses were increasing. The result showed that job stress increased for shift nurses. Especially, nurses of small-medium sized hospital showed remarkable effects to organization such as turnover intention. In addition, although the importance of approach to management is emphasized, there is little research on these aspects. 4) Practical Implications : It is necessary to develop systematic research on job stress directly effecting turnover intention of hospital nurses from hospital management aspect. The development of job stress measuring tools reflecting the characteristics of the medical institution, and the human resources management plan to resolve the imbalance in manpower for nurses should be required.