• 동의생리병리학회지
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• 제23권1호
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• pp.225-231
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• 2009

The purpose of this study was to compare the effectiveness of Dangkisoo-san(Dangguixu-san) and Gamihwalhyul-tang(Jiaweihuoxie-tang) herb-medication for the Traffic accident patient group with the effectiveness of common herb-medication for the general patient group by using 7-Zone-Diagnostic System. Two groups were selected from those who took the CP-6000A test in College of Oriental Medical Hospital of Sangji University from March 2007 to January 2008. Mean values of Factor AA on Skin Resistance Variability(SRV) of two groups were compared. The mean values of the deviation between measurement and 50 in pre-examination was higher than those of post-examination. Especially, there were remarkable difference between the mean values of the deviation between measurement and 50 in pre-examination and those of post-examination within the general patient group. When we compare pre-examination with post-examination in each area, 2 areas have remarkable difference within the general patient group. The mean values of positive deviation in pre-examination was higher than those of post-examination within both group. Especially, the TA patient group was remarkable. The other side the mean values of negative deviation in pre-xamination was remarkably higher than those of post-examination within the general patient group. By contraries the mean values of negative deviation in pre-examination was lower than those of post-examination within the TA patient group. These results suggest that Dangkisoo-san(Dangguixu-san) and Gamihwalhyul-tang(Jiaweihuoxie-tang) herb-medication will be less effective for chronic and weak traffic accident patients.

• 대한간호학회지
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• 제44권1호
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• pp.64-74
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• 2014

Purpose: This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. Methods: This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. Results: The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. Conclusion: The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.

• 보건의료산업학회지
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• 제10권1호
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• pp.13-26
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• 2016

Objectives : The aim of this study was to investigate whether there is a difference in the factors affecting the financial performance and profitability before and after the specialty hospital designation and thereby identifying the differentiated significance of the financial performance of specialty hospitals. Methods : Based on the year 2011, the analysis period was divided into the pre-specialty hospital designation (2007-2010) and post-specialty hospital designation (2011-2014), and the data were pooled according to the respective analysis period and analyzed by descriptive statistics and regression analysis. Results : The difference in the financial factors that affected the financial performance and profitability before and after the specialty hospital designation was discovered, and a financial performance factor different from prior studies was found. Conclusions : This study identified improved outcomes in financial performance due to the specialty hospital designation and the factors that affect profitability in terms of the finance of specialty hospitals.

• 의료법학
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• 제9권1호
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• pp.319-382
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• 2008

As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.473-478
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• 2016

Hepatocellular cancer is a very common cause of cancer related deaths worldwide. Only 30-40% of patients present with early-stage disease open to curative treatments, such as resection or transplantation, while others can only undergo local therapies or palliative care. Various trans-arterial approaches have been used for treatment of hepatocellular carcinoma in patients who need a down-staging to liver transplantation, and who are not candidates for transplantation or radiofrequency ablation. Transarterial chemoembolization (TACE), transarterial embolization (TAE), drug-eluting beads, and radioembolization have been used for locoregional control, and have been shown to prolong the overall survival when compared with supportive care. In this review, we discuss patient selection, pre- and post-procedure imaging, techniques, safety, and clinical outcomes related to these therapies. Newer advances with future directions in various fields related to trans-arterial therapies are also discussed.

• 한방재활의학과학회지
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• 제20권2호
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• pp.101-111
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• 2010

Objectives : The purpose of this study was to investigate differences between traffic accident and non-traffic accident patients in the early stage, by analysis of the heart rate variability(HRV) and visual analogue scale(VAS). Methods : This study carried out on 38 patients who complained of nuchal or lower back pain. They have received hospital treatment in Dae-Jeon Univ. Cheonan Oriental Hospital. In the TA(Traffic accident) group, the pain caused by TA and in non-TA group, the pain caused by other reasons. We measured HRV and VAS twice(pre-treatment(Tx.) and post-Tx.). Then we analyzed the data. Results : As time goes by, patients who complained of pain showed the inclination to improve ability to balance autonomic nerve system. And fatigue and pain were improved. But they showed the inclination to increase stress index. At pre-Tx., TA group had more stress and worse ability to balance autonomic nerve system, but showed lower fatigue index than non-TA group. But, as time goes by, in TA group the fatigue and autonomic balance got worse. At pre-Tx., non-TA group complained of more severe pain than TA group, but at post-Tx., TA group complained of more severe pain than non-TA group. In other words, in TA group, the decreasing rate of pain was lower than non-TA group. Conclusions : Results from this investigation showed that TA have a negative effect on stress index, ability to balance autonomic nerve system, fatigue index and decreasing rate of pain. These results are expected to consider characteristics of patients who complained of pain caused by TA.

• 한국응급구조학회지
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• 제9권2호
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• pp.29-38
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• 2005

The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

• 한국건설관리학회논문집
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• 제5권3호
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• pp.153-165
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• 2004

현재 국내의 종합병원 건축 시 "설계단계"에서는 초기단계에서부터 병원 관리자의 병원 운영정책 및 실사용 주체인 의료진의 의견반영이 미흡하고 의료장비, 의료경향의 신속한 변화로 인하여 잦은 설계변경이 발생하며 "시공단계"에서는 병원이라는 공사의 특성에 대한 공사 관련자들의 이해부족으로 인하여 재시공이 발생되어 국내 병원공사 프로젝트 수행과정 중 공사비 증가 및 공기지연 등의 문제점이 매우 빈번하게 발생되고 있다. 본 논문에서는 전문가 면접조사 및 사례조사를 통하여 병원공사의 시공성 저해 요인을 조사하고, 파트너링 기법을 분석하여, 병원건축의 시공성 증대 방안으로 시공이전단계에 파트너링을 활용한 병원건축의 '의료 지식/정보공유 시스템'을 제안하였다. 제안된 시스템을 검증하기 위하여 실제 대형병원프로젝트에 적용하여 파트너링을 활용한 대형 병원건축에서의 시공성 증대를 위한 파트너링 모델의 적합성을 확인하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4121-4126
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• 2013

Objective: Low dose radiation may stimulate the growth and development of animals, increase life span, enhance fertility, and downgrade the incidence of tumor occurrence.The aim of this study was to investigate the antitumor effect and hormesis in an erythrocyte system induced by low-dose radiation. Methods: Kunming strain male mice were subcutaneously implanted with S180 sarcoma cells in the right inguen as an experimental in situ animal model. Six hours before implantation, the mice were given 75mGy whole body X-ray radiation. Tumor growth was observed 5 days later, and the tumor volume was calculated every other day. Fifteen days later, all mice were killed to measure the tumor weight, and to observe necrotic areas and tumor-infiltration-lymphoreticular cells (TILs). At the same time, erythrocyte immune function and the level of 2,3-diphosphoglyceric acid (2,3-DPG) were determined. Immunohistochemical staining was used to detect the expression of EPO and VEGFR of tumor tissues. Results: The mice pre-exposed to low dose radiation had a lower tumor formation rate than those without low dose radiation (P < 0.05). The tumor growth slowed down significantly in mice pre-exposed to low dose radiation; the average tumor weight in mice pre-exposed to low dose radiation was lighter too (P < 0.05). The tumor necrosis areas were larger and TILs were more in the radiation group than those of the group without radiation. The erythrocyte immune function, the level of 2,3-DPG in the low dose radiation group were higher than those of the group without radiation (P < 0.05). After irradiation the expression of EPO of tumor tissues in LDR group decreased with time. LDR-24h, LDR-48h and LDR-72h groups were all statistically significantly different from sham-irradiation group. The expression of VEGFR also decreased, and LDR-24h group was the lowest (P < 0.05). Conclusion: Low dose radiation could markedly increase the anti-tumor ability of the organism and improve the erythrocyte immune function and the ability of carrying $O_2$. Low-dose total body irradiation, within a certain period of time, can decrease the expression of hypoxia factor EPO and VEGFR, which may improve the situation of tumor hypoxia and radiosensitivity of tumor itself.

• 한국임상약학회지
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• 제32권2호
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.