• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.47-61
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• 2017

Purpose: This study aims to suggest the spatial composition and area of the intensive care units through analysis of current situation for the standards establishment of the intensive care units in public district hospitals in the future. Methods: Three Methods have been used in this paper. 1) Literature reviews about composition, location, foreign standards on intensive care units. 2) Comparative analysis on the architectural drawing for the space program and the area. 3) Field survey in order to confirm differences between architectural drawing and current situation. Results: 1) The intensive care units is required to be linked by the operating department, the emergency department and the sterile supply department upon considerations of accessibility of emergency patients and the infection control. 2) The intensive care unit consists of five areas such as the patient area, the medical staff area, the material and equipment area, the patient family area, and the public area. 3) The location of spaces in the intensive care unit is classified by three methods such as connection by view, circulation and connection to corridor. The [table 20] summarizes the type of space and the average size of the space in intensive care unit. Implications: This study is a basic research for guideline of intensive care units, and need to be followed by further study using various perspectives and methods in the future.

• 간호행정학회지
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• 제13권3호
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• pp.352-361
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• 2007

Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.3919-3925
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• 2015

방사성옥소 치료를 받은 환자가 격리 후 차량으로 귀가할 때 동승자가 받는 방사선 피폭량을 줄이기 위해서는 동승하는 시간을 적절하게 제한해야 한다. 계산 방법이 어렵기 때문에 현재까지 일반적인 가이드라인은 있어도 환자 개개인의 상태를 반영하는 기준은 없었다. 그런데 비교적 짧은 이동시간 동안에는 소변을 통한 배출이 없고 물리적인 붕괴도 없다는 가정을 하면 총선량 = 선량율 ${\times}$ 이동시간이라는 아주 간편한 계산을 할 수 있다. 입원했던 환자 120명의 데이터를 활용하여 이 간편계산법과 표준적인 계산법으로 계산한 결과를 비교하였다. 이동가능 시간을 계산했을 때 간편계산의 결과는 표준적인 방법에 비해 0.3 m 거리에서는 56%, 0.5 m 거리에서는 91%, 1 m 거리에서는 96%였다. 간편계산법은 안전한 방법이며, 방사선안전관리 방법으로 쉽게 적용할 수 있을 것이다. 또한 방사성옥소 치료를 받는 갑상선기능항진증 환자에서도 적용이 가능하다.

• 한방안이비인후피부과학회지
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• 제30권4호
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• pp.75-96
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• 2017

Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

• 대한한의학원전학회지
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• 제34권2호
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• pp.1-22
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• 2021

Objectives : A transition course of 'Introduction to Clinical Korean Medicine' was developed to meet the demands for better preparation for clinical application of Korean Medicine within the curriculum. A Korean Medical Classics curriculum reflecting such demands was newly designed. Methods : Based on the 'Introduction to Clinical Medicine(ICM)' course of the Medical School curriculum that follows the medical education guideline, the 'Introduction to Clinical Korean Medicine(ICKM)' course was designed and developed. The role of Korean Medical Classics was suggested in the process. Results : In the following course, Korean Medical diagnosis, diagnostics, patient intake methods reflecting the Korean Medical diagnostic system, clinical skills, basic skills, treatment planning, patient education, etc. are included. Faculty members of the basic sectors of the Korean Medical school will participate in this curriculum, of which a head will be appointed to overlook the curriculum. In the case of Korean Medical Classics, previous learning outcomes need to be reorganized based on clinical expression while clinical case studies need to be added to course material. A more active approach utilizing new pedagogic strategies and teaching methods should be taken. Conclusions : The Korean Medical Classics curriculum could effectively take on the introductory role to clinical Korean Medicine, successfully strengthening the connection between the basic and clinical Korean Medicine to improve learners' satisfaction.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권3호
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• pp.15-23
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• 2019

Purpose: As the medical laboratories in general hospitals have made an efforts on quality management and employee health, they recognized the need of design guideline for clinical laboratory. As laboratories are prohibited to patients, their environments are becoming more congested and deteriorated as time goes by. So, this study investigates the current status of facility and equipment of laboratory medicine focusing on less than three hundred patient bed hospitals, and searches the improving matters. Methods: Questionnaires to technologist captains and field surveys to medical laboratories in korean hospitals have been conducted for the data collection. 18 answers have been analysed statistically by MS Excel program. Results: The result of this study can be summarized into followings. Clinical laboratory functions are all hematology, clinical chemistry, immunology, transfusion and urine microscopy, and except for three including microbiology for infection and bio safety level. Average man power of lab are 12.3 man including lab director and captain. Patient bed number, space area and total specimen numbers are not correlated with each other, but specimen numbers and employee number are correlated with. Work space distances are usually good, but exit distances are not adequate for escape owing to obstacles. Specimen delivery system by courier, test method by automatic analyzer, access floor for exposed plumbing and electricities are more practical. Open lab layed out in the center and lab support layed peripheral in space diagram. Lab space configuration by SD method showed that lab support area and employee support area are dissatisfied. Implications: Specialized hospital and yearly total specimen numbers are related to the space area and organization for laboratory planning and design.

• 척추신경추나의학회지
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• 제16권1호
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• pp.91-105
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• 2021

Objectives A case report is a detailed medical description of previously unreported observations or complications of medical conditions, unique use cases of tests, or new side effects. The purpose of this study was to evaluate the quality of case reports published in the Journal of Korea CHUNA Manual Medicine for Spine & Nerves (JKCMSN). Methods Case reports published in the JKCMSN from January 2013 to December 2020 were selected using the Oriental Medicine Advanced Searching Integrated System (OASIS). The quality of the reports was assessed based on the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines. Results Sixty case reports that met the inclusion criteria were included in the assessment. Our analysis revealed that 71.42% of the case reports included all the necessary information and their level of reporting was good. However, their scores in the qualitative subdivisions of the reporting level parameters showed that the quality level was uneven. More than 65% of the papers did not report in the following categories: "Keywords," "Patient information," "Timeline," "Diagnostic assessment," "Therapeutic interventions," "Follow-up and outcomes," "Patient perspective," and "Informed consent." Conclusions Our analysis shows that CARE guidelines need to be followed more rigorously to improve the quality of reporting in the JKCMSN. Further efforts are necessary to develop reporting guidelines and evaluation tools relevant to the Korean clinical context.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.62-65
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• 2017

2013년 실제 임상에 Gemcitabine과 nab-paclitaxel 병용요법이 적용된 후 NCCN Guideline에서 절제 불가능한 췌장암 환자에서 일차적으로 선택할 수 있는 약제로 제시하고 있다. 이 병용요법으로 인한 가장 흔한 Grade 3 부작용으로는 호중구감소증, 피로, 말초신경병증이 보고되었으며, 심장독성은 흔하지 않다. 본 증례에서는 심장표지자의 상승 및 심초음파에서의 우측관상동맥의 허혈 손상이 확인되어 병용요법으로 인한 심장 허혈 손상 및 심낭삼출물이 발생하여, 심장성 쇼크로 사망하였을 것으로 추정해 볼 수 있다. Gemcitabine과 nab-paclitaxel에 의한 심장 허혈 손상의 더 많은 증례 보고 및 연구가 필요하며, 병용요법을 투여 받는 환자들에 대한 심장독성에 대하여 주의 깊은 관찰이 필요할 것으로 생각된다.

• Korean Journal of Radiology
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• 제24권7호
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• pp.606-625
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• 2023

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.186-193
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• 2024

Objective : The treatment paradigm for acute ischemic stroke has undergone several major changes in the past decade, contributing to improved patient prognosis in clinical practice. However, the extent to which these changes have affected patient prognosis in the real-world is yet to be clarified. This study aimed to evaluate the real-world impact of modern reperfusion therapy for acute ischemic stroke using data from the National Health Insurance Service in Korea. Methods : This study included patients aged 18-80 years who were admitted via the emergency room with an I63 code between 2011 and 2020. The rates of intravenous thrombolysis use and endovascular treatment according to the year of admission were investigated. Furthermore, the rates of decompressive craniectomy and 3-month mortality were also analyzed. The 10-year observational period was divided into three periods based on the 2015 guideline change as follows : prior, 2011-2014; transitional, 2015-2016; and modern, 2017-2020. Results : A total of 307117 patients (mean age, 65.7±10.9 years) were included, and most patients were male (59.7%). The rate of endovascular treatment gradually increased during the study period from 0.71% in the prior period to 1.32% in the transitional period and finally to 1.85% in the modern period. Meanwhile, the 3-month mortality rate gradually decreased from 4.78% in the prior period to 4.03% in the transitional period and to 3.71% in the modern period. Conclusion : In Korea, the mortality rate decreased as the rate of modern reperfusion therapy increased in patients with acute ischemic stroke. Overall, technical and scientific advances in reperfusion therapy have improved the outcome of patients with acute ischemic stroke in Korea.