• Clinical and Experimental Reproductive Medicine
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• 제43권3호
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• pp.146-151
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• 2016

Objective: This study was conducted to compare the effects of static culture, dynamic culture, and the combination of dynamic culture with specialized surfaces involving co-culture on human embryonic development. Embryos cultured using conventional static culture (SC) techniques served as a control group. We compared dynamic culture using micro-vibration culture (MVC) and micro-vibration with co-culture (MCoC), in which autologous cumulus cells were used as a specialized surface. Methods: We conducted a chart review of patients who were treated between January 2011 and November 2014 in order to compare embryonic development rates and pregnancy rates among the groups. Zygotes were cultured in micro-droplets, and embryos were subsequently selected for transfer. Some surplus embryos were cryopreserved, and the others were cultured for blastocyst development. A micro-vibrator was set at the frequency of 42 Hz for duration of 5 seconds per 60 minutes to facilitate embryo development. Results: No significant differences among the groups were present in patient's characteristics. However, the clinical pregnancy rates were significantly higher in the MVC group and the MCoC group than in the SC group. No significant differences were found in the blastocyst development rate between the SC group and the MVC group, but the blastocyst development rate in the MCoC group was significantly higher than in the SC and MVC groups. Conclusion: The clinical pregnancy rate was significantly increased by the application of micro-vibration to the embryonic cultures of poor responders. The blastocyst development rate was significantly increased by the application of MCoC to surplus embryos.

• 한국산학기술학회논문지
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• 제16권7호
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• pp.4641-4650
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• 2015

본 연구는 지방의료원의 고객세분화를 통하여 향후 전문화된 의료기관으로 진료전문성을 강화하여 경쟁력을 확보할 수 있는 진료전문화 전략을 제시하는데 목적이 있다. 조사기간은 2013년 1월부터 12월까지 입원한 환자 26,658명을 연구대상을 선정하였다. 분석방법은 군집분석과 의사결정나무분석을 이용하였다. 결론을 보면, 성별은 여자, 연령은 60세 이상, 질환별로는 근 골격계 및 결합조직의 질환이 충성고객으로 선정되었다. 이들은 지방의료원의 고객관리측면에서 향후 구전의 효과가 높은 고객 군으로 금전적인 소비규모가 높은 점을 고려하여 이들에게 제공된 의료서비스에 대한 모니터링과 커뮤니케이션을 통해 지속적인 관계를 유지하는 것이 중요하다. 앞으로 전문 분야의 전문의와 전문적 시설 확보 등의 적합한 조직구조와 환경을 갖추는 것이 중요하며, 지역 내 개원의, 유관기관간의 전략적 제휴 통한 진료협력 및 의뢰, 의료서비스 범위의 집중화가 필요하다.

• Journal of Trauma and Injury
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• 제29권1호
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• pp.8-13
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• 2016

Purpose: Specialized general trauma surgeons play an important role in the care of trauma patients. Hemoperitoneum is a severe, but representative, condition following a life-threatened trauma. The objective of this study was to compare the outcomes for polytrauma patients with hemoperitoneum between the periods during which a trauma surgeon was available and that unavailable. Methods: Thirty-one trauma patients with hemoperitoneum who were treated at Korea University Guro Hospital over a period of 4 years were included in this study, and their case records were analyzed retrospectively. The patients were divided into two groups, the 2011 and 2012 group and the 2013 and 2014 group corresponding, respectively, to the periods that a trauma surgeon was not and was working. Vital signs on admission, scores on the injury severity scale and, Glasgow coma scale, elapsed time to diagnostic, and therapeutic, and/or operative interventions were studied. The effects on intensive care unit and hospital lengths of stay, as well as mortality, were also studied. Results: The study population consisted of 16 and 15 patients in group 1 and 2, respectively. The patients in both groups had six unstable hemodynamic on admission. The time to the main procedure (intervention, operation etc.) was longer during the periods when a trauma surgeon was not working than it was during the period when working. This difference did not reached statistical significance. The mortality rates for the two groups were not statistically different either (18.75% vs 26.67%; p=0.928). Conclusion: Having at least one specialized general trauma surgeon on duty may reduce the time to intervention and surgery for severe trauma patients with hemoperitoneum, but appears to have no effect on the mortality rates. In conclusion, having only one trauma surgeon on duty does not improve the quality of care for trauma patients.

• 한국노년학
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• 제28권4호
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• pp.773-784
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• 2008

본 논문은 한국노년학회지의 노인보건정책연구와 관련된 게재논문의 내용을 분석하여 그 유형과 주요 정책제언의 내용을 정리하고, 이를 바탕으로 향후 우리나라의 노인보건정책에서 추구하여야 할 정책과제를 도출, 제시하는데 있다. 지난 한국노년학회지가 발간된 이후부터 2007년도까지 노인보건과 관련된 게재논문수는 총 61편이었고, 이 중에서 정신보건분야, 구강보건분야를 제외한 질병, 의료비 등 일반보건의료와 관련한 연구가 대부분을 차지하고 있다. 연구방법론을 보면, 특정지역에 거주하는 노인을 대상으로 하되 표본조사를 통해서 구축된 자료와 노인복지기관이나 병원 등을 이용한 노인을 분석대상으로 한 논문이 대부분을 차지하고 있다. 이를 바탕으로 제시할 수 있는 향후 정책과제는 다음과 같다. 첫째, 노인의 건강수준에 적합한 특화된 건강증진프로그램의 개발 및 활성화방안을 강구하여야 할 것이다. 둘째, 지역사회중심의 노인 일차보건의료체계의 구축이 강구되어야 할 것이다. 셋째, 급성기 치료 이후의 회복기 치료를 저렴한 비용으로 제공할 수 있는 체계를 구축하여야 할 것이다. 마지막으로 장기요양서비스를 필요로 하는 노인환자에 대한 의료적 관리체계를 구축하여야 할 것이다.

• 대한방사선협회지
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• 제28권1호
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• pp.74-82
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• 2002

1. Purpose Presently, the service areas of those who we engaged in radiation works are being specialized. Thus, in this study, we propose a way for efficiently improving mutual relationship between the works of the radiation technicians(radiologists) and

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.39.1-39.5
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• 2020

Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.

• 대한물리치료과학회지
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• 제13권2호
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• pp.99-119
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• 2006

Endothelin (ET) is a 21 amino acid peptide with multifunctional effects on the vasculature as well as a variety of other cell types such as respiratory, gastrointestinal, urogenital, endocrine, central nervous systems, and others. Endothelin has emerged as a modulator by autocrine and paracrine actions for many cellular activities, including vasoconstriction, cell proliferation, hormone production, neurotransmitter and/or neuromodulator. The endothelin family consists of three closely related peptides, ET-1, ET-2, and ET-3 derived from separate genes, such as chromosome 6, 1, and 20, respectively. ET-1 is the predominant isoform produced in the cardiovascular system and about which most is known. Endothelin receptors are seven-transmembrane GTP-binding protein-coupled receptors, which are classified into endothelin-A (ETA) and endothelin-B (ETB) receptors. Interestingly, recent evidence is accumulating to suggest that ET -1 may contribute to a variety of pain states such as allodynia and hyperalgesia in animals and humans. Therefore, in this review the biological characteristics and contraction-related mechanism of endothelin-1 in mammalian cells will be summarized. Especially, we focus on multifunctional roles for ET-1 in noxious stimulation-induced pain for the study of pain specialized physical therapy.

• 한국산학기술학회논문지
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• 제17권3호
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• pp.489-498
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• 2016

본 연구는 전문병원 간호사가 지각한 내부마케팅과 고객지향성이 조직몰입에 미치는 영향을 규명하기 위한 서술적 조사연구이다. 대상자는 B광역시 소재 5개 전문병원에서 6개월 이상 근무한 간호사 149명이며, 자료수집기간은 2015년 5월 01일에서 2015년 5월 30일까지였다. 수집된 자료는 t-test, ANOVA, Scheffe's test, Pearson's correlation coefficients와 multiple regression으로 분석하였다. 연구결과 대상자의 조직몰입 정도는 연령, 결혼유무, 교육정도, 임상경력, 직위, 근무형태, 근무부서, 병상 수, 내부고객만족조사 유무에 따라 통계적으로 유의한 차이가 있었다. 조직몰입은 내부마케팅과 높은 상관관계가, 고객지향성과는 낮은 상관관계가 있는 것으로 나타났고 통계적으로 유의하였다. 조직몰입을 설명하는 유의한 변수는 내부마케팅, 근무부서, 교육정도, 직위 순이었고, 전체 설명력은 58.5%이었다. 따라서 전문병원 간호사의 조직몰입을 높이기 위해서는 간호사의 전문성을 높이기 위한 교육의 기회를 제공하고, 근무환경을 개선하며, 정기적인 만족도 조사를 실시하는 등의 내부마케팅 전략의 개발이 필요하다.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.60-68
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• 2023

Purpose: For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. Methods: This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. Results: During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P<0.001). Conclusion: To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권1호
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• pp.17-27
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• 2019

Purpose: Clinical laboratory in hospital has taken a great role in protection of chronic disease. as well as diagnosis and treatment, And laboratory layout has been considered by the management and laboratory section more than the function and workflow. Methods: So this study figures out the workflows of laboratory sections in the recently upgraded Laboratory Medicine, and searches the functional relationships and spatial block diagram between each disciplines as follows. Literature review and expert adviser has been conducted. Results: 1) Laboratory type of Laboratory Medicine is divided into routine and specialized laboratory according to the workflow by automated or specialized test. 2) The general workflow consists of specimen collection, specimen classification, test by discipline, test report, and specimen disposal. 3) Though the function of each laboratory section is very complicated and specific, the characteristics and the workflow can be shown in detail by each lab through [Figure 4], [Figure 5], [Figure 6], [Figure 7], and [Figure 8]. 4) Functional relationship diagram can be displayed to the adjacency and relation between each laboratory and support spaces. 5) The spatial block diagram could be presented as shown in [Figure 10], in which the emergency lab lay in front side, routine lab in the central open area, and specialized lab in the behind side. Implications: This study can be used as a useful data in planning and designing a Laboratory Medicine Department.