• Archives of Plastic Surgery
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• 제49권5호
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• pp.652-655
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• 2022

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

• 지능정보연구
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• 제14권2호
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• pp.21-44
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• 2008

최근 유비쿼터스 컴퓨팅 환경에서 등장하고 있는 각종 서비스들은 공통적으로 상황인식 컴퓨팅(context-aware computing)의 속성을 갖고 있다. 사용자를 둘러싼 다양한 상황(context)을 인식하여 다른 곳으로 정보를 전송하거나 지능적인(intelligent) 서비스를 제공해주는 것을 유비쿼터스 컴퓨팅 서비스의 기본 속성이라고 할 때, 유비쿼터스 컴퓨팅 서비스는 웰빙케어(well-being care) 분야에도 적용될 수 있다. 본 연구는 상황인식 컴퓨팅의 속성을 스트레스 관리를 위한 새로운 서비스에 적용해 봄으로써, 스트레스 정도를 객관적으로 측정할 수 있고 스트레스를 줄여주는 개인화 된 항스트레스(personalized anti-stress) 서비스를 제공할 수 있는 방법을 고안하였다. 이를 위해 본 연구는 스트레스 지수 모델(stress index model)을 개발하고, 스트레스를 측정하여 그에 맞는 항스트레스 서비스를 제공할 수 있는 방법론적인 접근을 시도하였다. 또한, 데모시스템의 테스트를 통해 스트레스 지수 모델의 기술적 구현 가능성을 확인하였다. 뿐만 아니라, 이와 같은 방법들을 사업적 관점에서 실제 적용할 수 있는 방법의 하나로서, 스트레스 측정과 관리를 주 목적으로 하는 u-SMC(Stress Management Center)의 비즈니스 모델을 개발함으로써 스트레스 관리를 위한 유비쿼터스 컴퓨팅 서비스의 상용화 가능성도 살펴보았다.

• 한국학교보건학회지
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• 제13권2호
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• pp.341-347
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• 2000

Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.61-69
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• 2007

Physiotherapy may be defined as the use of physical techniques for the treatment of injuries and movement dysfunction. In the world of human medicine, physiotherapy has been proven as an indispensable aid in the recovery of many musculoskeletal conditions, as evidenced by the extensive physiotherapy departments within most hospitals. Nowadays, this important branch of medicine is also rapidly becoming a recognised tool in the prevention, cure, and rehabilitation of many equine, canine and feline injuries. In 1978, canine physical therapy techniques were described by Ann Downer, a physical therapist on faculty at Ohio State University. Animal physical therapy is a new and rapidly developing field of health care for animals. The benefits of physical therapy have long been recognized in humans. More recently, work in the veterinary field has shown the same benefits of physical therapy to be true for animal patients. Performing orthopaedic or neurological surgery, or fitting a human patient with a cast or splint, and then discharging the patient is an outdated approach. In such cases, physical therapy is clearly warranted. Similarly, recent research has shown that post-surgical rehabilitation and therapy after injuries significantly improves the functional outcomes for animals. The goals of physiotherapy are to relieve pain, restore range of motion/movement, improve function, prevent injuries and expand the physical potential of the patient. Once in the field, physical therapists actively continue their education to keep up to date on the latest treatments and technologies. Via continuing education courses, physiotherapists can learn how to apply their unique and specialized knowledge to other animal species.

• 디지털융복합연구
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• 제13권5호
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• pp.297-307
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• 2015

본 연구는 접근성과 의료서비스 품질, 대외적 이미지를 높임으로써 향후 지방의료원이 지역 내 대표의료기관으로서 경쟁력을 확보하고 경영효율성을 향상시키는데 그 목적이 있다. 조사대상은 604명으로 하였으며, 분석방법은 ANOVA, 공분산 구조방정식을 실시하였다. 결론을 보면, 의료기관 선택요인에 대한 고객들의 만족도나 선호도가 인구통계학적 특성별로 유의한 차이가 있다는 결과는 앞으로 지방의료원이 의료서비스 전문화 전략을 수립할 때 주요 고객집단의 욕구에 대한 면밀한 검토가 이루어져야 할 필요가 있음을 시사하고 있다. 또한 지방의료원이 진료비 수준에 대한 치료효과와 타 의료기관에 비해 저렴한 진료비가 경쟁우위를 확보할 수 있는 중요요인으로 이에 따른 이미지 부각과 의료서비스의 질의 향상을 극대화하여 의료소비자들을 유인하는 전략이 필요하다.

• 경영과정보연구
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• 제29권4호
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• pp.305-332
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• 2010

본 연구는 산림 건강치유, 요가, 휘트니스 등 총 세 가지의 건강관리 서비스 산업 비교를 중심으로 고객만족에 영향을 미치는 요인들을 찾고, 그로인한 어느 요인이 각 서비스 산업에서 고객만족에 많은 영향을 미치는가를 실증적으로 분석하여 검정하고자 하였다. 이에 기존의 SERVQUAL 척도를 중심으로 분석된 연구들과 또한 고객만족에 관한 측정지표 등을 사용하여 분석된 연구들을 바탕으로 프로그램, 물리적 환경, 직원의 서비스 지향성 등 3개의 요인을 도출하여 각 서비스 산업별로 다중회귀분석을 실시하였다. 분석결과, 산림 건강치유에서는 물리적 환경이, 요가에서는 프로그램이, 휘트니스에서는 직원의 서비스 지향성이 가장 많은 영향을 미치는 것으로 나타났다. 따라서 각 건강관리 서비스 산업은 고객들의 라이프스타일과 트렌드에 최우선적으로 역점을 두고 운영이 되어야 하며, 그에 따른 특성화 서비스를 제공해야 할 것으로 보여진다. 물론, 경쟁력을 갖추기 위해선 현대화된 운동장비와 차별화된 프로그램, 쾌적하고 고급화된 시설 마련은 기본이 되어야 한다. 더불어 현 시점은 건강과 운동에 대한 고객들의 관심이 양적 추구에서 질적 추구로 바뀌어가고 있다는 것도 직시해야 한다. 그 의미는 운동을 단순히 신체적 가치나 정서적 가치 추구에만 머물지 않고 교제나 유대를 위한 사회적 가치 추구에까지 미치도록 서비스를 변화시켜야 한다는 것이다. 이를 위해선 고객들 간의 유대관계를 위한 부가적인 프로그램 도입과 친근한 분위기, 적절한 동선체계도 함께 강구해야 할 필요성을 시사한다.

• 보건의료산업학회지
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• 제1권1호
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• pp.110-124
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• 2007

Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.

• 대한방사선기술학회지:방사선기술과학
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• 제44권5호
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• pp.545-554
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• 2021

According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.

• 대한영양사협회학술지
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• 제20권4호
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

• Journal of Chest Surgery
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• 제57권1호
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• pp.62-69
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• 2024

Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.