• 한국동물위생학회지
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• 제38권2호
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• pp.107-116
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• 2015

In this study, we developed a rapid, sensitive and specific reverse-transcriptase loop-mediated isothermal amplification (RT-LAMP) assay for detection of swine influenza viruse (SIV) including major subtypes of swine influenza viruses H1N1, H1N2 and H3N2, and a novel subtype of influenza A virus that accidentally infected in pig population. The RT-LAMP was completed in 40 min at $58^{\circ}C$ and the sensitivity of the RT-LAMP ($1copy/{\mu}L$) was 10-fold higher than conventional reverse transcription-polymerase chain reaction (RT-PCR) ($10copy/{\mu}L$) and the same to real time RT-PCR ($1copy/{\mu}L$). Also, the result of the RT-LAMP can be confirmed without any detection system. Therefore, the RT-LAMP could be a alternative diagnostic method for SIV detection in national SIV monitoring system and clinical diagnostic laboratory in the future.

• 보건의료산업학회지
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• 제8권1호
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• pp.151-164
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• 2014

This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

• Journal of Genetic Medicine
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• 제4권1호
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• pp.1-5
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• 2007

Unprecedented amount of genetic information being generated from the result of Human Genome Project (HGP) and advances in genetic research is already forcing changes in the paradigm of health and disease. The ultimate goal of genetic medicine is to use genetic information and technology to develop new ways of treatment or even prevention of the disease on an individual level for 'personalized medicine'. Genetics is play ing an increasingly important role in the diagnosis, monitoring and management of common multifactorial diseases in addition to rare single-gene disorders. While wide range of genetic testing have provided benefits to patients and family, uncertainties surrounding test interpretation, the current lack of available medical options for the diseases, and risks for discrimination and social stigmatization may remain to be resolved. However an increasing number of genetic tests are becoming commercially available, including direct to consumer genetic testing, yet public is often unaw are of their clinical and social implications. The personal nature of information generated by a genetic test, its power to affect major life decisions and family members, and its potential misuse raise important ethical considerations. Therefore appropriate genetic counseling is needed for patient to be informed with the benefits, limitations and risks of genetic tests, prior to informed consent for the tests. Physician also should be familiar with the legal and ethical issues involved in genetic testing to tell patients how w ell a particular genetic risk factor relates with likelihood of disease, and be able to provide appropriate genetic counseling. Genetic counseling become a mandatory requirement as global standard for many genetic testing such as prenatal diagnosis, presymtomatic DNA diagnostic tests and cancer susceptibility gene test for familial cancer syndrome. In oder to meet the challenge of genetic medicine of 21 century in korean health care system, professional education program and certification board for medical genetics specialist including non-MD genetic counselors should be addressed by medical society and regulatory policy of national health insurance reimbursement for genetic counseling to be in place to promote the implementation of clinical genetic service including genetic counseling for proper genetic testing.

• 대한본초학회지
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• 제36권5호
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• pp.1-14
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• 2021

Objectives : From January 2020, when the first confirmed case of COVID-19 in Korea, the use of health information using the Internet is expected to increase. It is expected that there will be a significant change in the general public's interest in Korean herbal medicines for health care. Therefore, in this study, we tried to confirm the change in the search trend of Korean herbal medicines after the COVID-19 epidemic. Methods : Using the "Naver DataLab (http://datalab.naver.com)" service of a Korean portal site Naver, search volume was investigated with 606 Korean herbal medicines as keywords. The search period was from January 2020, right after the onset of COVID-19, to June 2021. The search results were sorted by the peak search volume and the total search volume. Results : 'Cheonsangap (천산갑, 穿山甲, Manitis Squama)' was the most searched Korean herbal medicine in the peak search volume and total search volume with least bias. Conclusions : The problem of supply and demand of Korean herbal medicines of high public interest was identified. Broadcasting and media exposure were the factors that had a big impact on the search volume for Korean herbal medicines. As it was confirmed that the search volume for Korean herbal medicines increased rapidly due to media exposure, it is necessary to provide correct information about Korean herbal medicines, improve public awareness, and manage stable supply and demand based on continuous search trend monitoring.

• 대한예방한의학회지
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• 제28권1호
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• pp.1-11
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• 2024

Objectives : This study conducted a survey on the needs of Korean medicine doctors for health care education programs specializing in traditional Korean medicine. Methods : The study selected Korean medicine doctors who had experience participating in outpatient consultations. Data collected through surveys underwent frequency analysis on performance, importance, difficulty, and educational needs using SPSS 24.0. Additionally, an Importance-Performance Analysis (IPA) was conducted using importance and performance data. Results : According to the results of the IPA analysis, in the area of "keep up the good work" there were activities such as fee Claims (A3), comprehensive assessment (B4), care plan development (B5), client and caregiver interviews (C8), chronic disease monitoring (C9), musculoskeletal and other pain management, musculoskeletal rehabilitation (C10), mental health management (C11), and fall prevention (C15). In the "concentrate here" priority action area, skin care including pressure sore management (C13) was identified. Conclusions : The traditional Korean medicine community care service is expected to expand further, so it is anticipated that the developed educational programs will contribute to the activation of traditional Korean medicine health care business.

• 한국의료질향상학회지
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• 제11권1호
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• 한국동물위생학회지
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• 제36권4호
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• pp.243-248
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• 2013

Q fever is a rickettsial infection caused by Coxiella burnetii that is transmitted from animals to humans. Modes of transmission to humans include inhalation, tick bites and ingestion of unpasteurized milk or dairy products. This survey was aimed at monitoring the seroprevalence of C. burnetii in bulk-tank milk (BTM) in Gyeongbuk province. In addition, the seroprevalence of C. burnetii was investigated at the herd level of dairy cattle in eastern Gyeongbuk province in which many dairy cattle are reared. Among 324 BTM samples collected from 20 country areas, 175 (54%) BTM samples from 15 (75%) country areas were positive for C. burnetii by ELISA. By regions, the seroprevalence of BTM samples in eastern, central, western and northern areas of Gyeongbuk province were 62.7%, 48.4%, 45.1%, and 41.4%, respectively. When analyzed in the dairy cattle reared in the eastern area where high seroprevalence occurred in BTM samples, 119 (24.2%) out of 492 dairy cattle were positive for C. burnetii. Seroprevalence of C. burnetii in dairy cattle was increased with daily milk yield of farm (P<0.05) and age (P<0.001). Since seroprevalence of C. burnetii is relatively high in both BTM samples and dairy cattle reared in Gyeongbuk province, further studies on the high risk farms and herds are needed to evaluate infection status and appropriate control programs in this region.

• 한국동물위생학회지
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• 제36권3호
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• pp.171-180
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• 2013

This study was carried out to investigate the antimicrobial resistance pattern and distribution of resistance gene in 44 Enterobacteriaceae and 21 Pseudomonas (P) aeruginosa isolated from hospitalized dogs and cats in animal hospital from 2010 to 2011 in Daegu. Among Enterobacteriaceae, Escherichia (E) coli was highly resistant to ampicillin (56.7%), followed by tetracycline (53.3%), cephalothin, streptomycine, sulfamethoxazole/trimethoprim, gentamicin and norfloxacin (40.0~43.3%). The remaining isolates of Enterobacteriaceae had high resistance to ampicillin (64.3%) and streptomycin (42.9%). Whereas, P. aeruginosa was low resistant to all antimicrobials tested (less than 15%). int I 1 gene was detected in 20 (57.1%) of 35 antimicrobial resistant Enterobacteriaceae and 2 (9.5%) of 21 P. aeruginosa., but int I 2 gene was not detected in all isolates. The eight resistance genes were found either alone or combination with other gene (s): $bla_{TEM}$, aadA, strA-strB, clmA, tetA, tetB, sul I and sul II. About 78% of integron-positive isolates were resistance to more than four antimicrobial agents. The findings suggest that class I integrons are widely distributed in E. coli among Enterobacteriaceae from dogs and cats and multi-drug resistance related to the presence of class I integrons. The prudent use of antimicrobials and continuous monitoring for companion animals are required.

• 한국동물위생학회지
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• 제34권1호
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• pp.37-43
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• 2011

This study was conducted to investigate the prevalence and genotypes of extended-spectrum ${\beta}$-lactamase (ESBL) in 377 Escherichia coli isolated from healthy and sick animals. Two isolates (0.5%), each of which were isolated from diseased swine and chicken, respectively, were confirmed as ESBL producing isolates by double disk synergy test, and showed a multidrug resistant phenotype. Minimum inhibitory concentration of cefotaxime for the two ESBL producing isolates were 3~4 times higher than those of ceftazidime, respectively. By PCR and sequencing, one isolate from swine have both $bla_{CTX-15}$ and $bla_{TEM-1}$, and one isolate from chicken have $bla_{CTX-15}$ and $bla_{TEM-116}$. Also, these genes were transferred to E. coli J53 by conjugation. These two isolates showed unrelated pulsed-field gel electrophoresis. To our knowledge, this is the first time that $bla_{TEM-116}$ gene was identified in E. coli isolated from animals in Korea. These results suggest more prudent use of third- generation cephalosporins, and surveillance and monitoring for ESBL producing E. coli in both animals and their environments should be necessary.

• 한국의료질향상학회지
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• 제22권1호
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• pp.29-37
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• 2016

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.