• 의료법학
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• 제15권2호
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• pp.345-366
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• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• 한국치위생학회지
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• 제14권1호
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• pp.101-108
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• 2014

Objectives : The purpose of this study was to evaluate the tooth whitening effect of 0.74% and 2.80% hydrogen peroxide toothpastes and safety on tooth and gingival tissue. Methods : Toothpastes containing 0.74% and 2.80% hydrogen peroxide were evaluated. In in-vitro test, some additives (sodium metaphosphate, sodium pyrophosphate and titanium dioxide) were added to the toothpastes. Hydroxyapatite specimens (HAPs) were made and stained using modified Stookey's methods. HAPs were treated for 1 hour at shaking incubator and brushed for 1,000 times as 250 gF with each diluted toothpaste. Before and after color was measured by colorimeter. Using double blind method, 99 Korean with natural maxillary anterior teeth were selected and the initial brightness (baseline) was measured by SHADEEYE-EX. Based on this measurement they were crossly distributed into control group (0% hydrogen peroxide), test 1 (0.74% hydrogen peroxide) and test 2 (2.80% hydrogen peroxide). After 2 weeks, people of each group were provided toothpaste and told to use 3 times a day right after every meal for 3 minutes. The brightness of teeth was measured 3 times for every one month. Results : ${\Delta}L$ was statistically significant among three groups in shaking test. ${\Delta}L$ of two test groups was statistically significant compared with control group but not between each test group in brushing test. After using toothpaste for 3 months, test 1 group and test 2 group were 15.89% and 31.23% more whitened compared with control group respectively (p<0.05). Rate of more whitened person of each test group was 24.2% and 40.5% more than control group respectively (p<0.05). There was no difference in the hypersensitivity during 3 months using toothpastes and no side effect on teeth or gums. Conclusions : Toothpastes containing 0.74% and 2.80% hydrogen peroxide showed tooth whitening effect and both were safe enough to use for tooth whitening.

• 중환자간호학회지
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• 제1권1호
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• pp.33-45
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• 2008

Purpose: Patients who underwent a coronary artery bypass graft surgery(CABG) experienced the unpleasant emotions and discomfort when their chest tube was removed. The purpose of this study was to evaluate the effects of cold therapy on pain related to chest tube removal(CTR) in CABG patients. Methods: Fifty adult patients undergoing CABG were recruited in a prospective, double blinded study. Subjects were divided into the experimental group and the control group considering their sex and age. The pretest data were obtained 20 minutes before CTR. Patients in the experimental group, received cold therapy for 10 minutes before CTR. Pain sense and intensity were determined immediately after CTR and at 10 minutes after CTR. Results: The total score of pain sense immediately after CTR of the experimental group was significantly lower than that of the control group(t=-3.703, p=.003). And scores of pain intensity immediately after CTR in the experimental group were significantly lower than that of the control group(t=-3.073, p=.001). But, there was no significant difference in the score of pain intensity 10 minutes after CTR between the experimental and the control group(t=1.759, p=.085). Conclusion: The cold therapy would be recommended as an effective and nonpharmacologic nursing intervention for relieving pain in patients undergoing CTR.

• Journal of Korean Biological Nursing Science
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• 제19권4호
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• pp.227-240
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• 2017

Purpose: The purpose of this review was to identify the current status of nursing studies on heart failure (HF) patients in South Korea and to suggest future study direction. Methods: A literature review of databases such as KoreaMed, KERIS and nursing and allied health journal were searched with key terms 'heart failure' and 'nursing' for the period from January 2000 to February 2017. A total of 35 studies including 28 articles and 7 theses met the inclusion criteria. Results: Twenty-seven out of 35 studies were observational studies on outpatients and most of the studies did not mention the ejection fraction and New York Heart Association functional classification class (NYHA class) in the inclusion criteria. Self-care and health-related quality of life as psychological factors, and physical activity as a biological factor, were used as main variables. However, we found it difficult to understand how much score indicates better quality of life because of an inconsistent and wide score. In quality assessment, 8 intervention studies had no serious flaws. Conclusion: Further studies should consider more biological and social factors influencing HF. The quality assessment with respect to nursing intervention studies in HF showed that randomized and double-blind trials are needed.

• 센서학회지
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• 제32권6호
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• pp.412-417
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• 2023

There is increasing interest in the rapid and highly sensitive monitoring of cell viability in biological and toxicological research. Conventional methods depend on optical assays using Water Soluble Tetrazolium-8 (WST-8) or 3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide (MTT) assay, which requires a large volume of samples and special instruments, necessitating shipment of clinical samples to laboratories. This paper reports on the development of a rapid and sensitive electrochemical (EC) sensor using screen printed electrode (SPE) and surface modification using 4'-mercapto-N-phenylquinone diamine (4'-NPQD), as double electron mediators, for monitoring cell viability via the measurement of nicotinamide adenine dinucleotide (NADH). We used the sensor to observe the viability of MCF-7 and doxorubicin (Dox)-treated cells. The oxidation current of NADH was measured via chronoamperometry (CA), and the EC results showed a good linear relationship when compared with NADH quantification using WST-8 assay. The analysis time was only 10 s and limit of detection (LOD) of NADH was 1.78 µM. Our EC method has the potential to replace conventional WST assays for cell viability and cytotoxicity experiments.

• 지적과 국토정보
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• 제49권2호
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• pp.109-122
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• 2019

맞벌이 가구의 증가로 육아에 대한 사회적 관심이 커지고 있다. 특히 자녀의 초등학교 입학은 상대적으로 이른 하교시간 때문에 돌봄의 공백이 생겨 출산과 더불어 여성의 경력단절에 주된 원인으로 꼽힌다. 본 연구는 이러한 정책적 기조에 부합하여 초등학생 대상 돌봄시설의 최적 입지선정 방안을 제안하였다. 돌봄시설의 후보로 기존 아이돌봄시설을 대상으로 하였으며, 최적입지 선정 시 수리적 최적화뿐만 아니라 입지적 특성을 고려하는 이중구조의 평가방법을 사용하였다. 실험은 서울시 송파구를 대상으로 진행하였으며, 총 258개의 후보시설 중 36개의 최적입지를 선정하였다. 먼저 공공데이터를 활용하여 돌봄시설의 특성에 맞는 평가기준을 세운 후 입지점수를 매겨 이에 해당하는 1차 후보시설을 선별하였으며, 이때 다양한 공공데이터를 하나로 통합하기 위하여 격자리샘플링 방법을 사용하였다. 다음으로 선별된 시설을 대상으로 공간 최적화 모델인 p-median 방법을 활용하여 최종 돌봄시설을 선정하였다. 이렇게 선정된 결과는 총 거리를 고려한 위치적 최적해 일뿐 아니라 돌봄시설의 특성을 고려한 다양한 입지적 기준을 만족하는 값이다. 본 연구에서 제안한 방법을 통해 공공데이터 융합 및 활용도를 높일 수 있고, 공공시설 최적입지 선정 시 정책 의사결정에 도움을 줄 것으로 기대한다.

• 한국가족복지학
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• 제61호
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• pp.59-91
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• 2018

본 연구는 노인환자 치료경험이 있는 노인 의료전문가를 대상으로, 그들이 인식하는 연령주의를 확인하는 동시에, 이러한 장벽을 없애기 위하여 연령통합적인 차원의 노력과 경험들을 어떻게 해왔는지에 초점을 둔다. 연구대상자인 9명의 의료전문가들의 연령주의와 연령통합에 대한 보다 다양한 인식과 경험을 담아내기 위해 CQR 질적연구 방법을 활용해 분석하였다. 의료전문가들은 연령주의(Ageism)에 대한 자기고백의 이중성을 보이고 있었으며, 의료현장에서는비적정진료, 노인 소외와 보호자 의존, 양극화 된 서비스와 빈곤노인에 대한 이중차별의 방식으로 연령주의가 실재(實在)하고 있었다. 이를 완화 혹은 해결하기 위한 방안으로서의 연령통합적 의료서비스 제공에 대해 어려움을 느끼고 있었으나, 소통을 위한 장벽 허물기를 추구하거나, 노인 뿐 아니라 모두에게 보편적(universal)으로 편안한 환경을 제공하거나, 제도와 서비스 기준을 확대 및 다양화하는 방식으로 연령통합적 서비스를 위한 적용노력을 하고 있는 것으로 나타났다. 급격히 증가하는 노인환자들의 건강한 삶과 적정한 의료서비스 보장을 위해첫째, 연령주의를 가속화 시키는 한국 의료체계 내 요소들에 대한 비판적 고찰, 빈곤노인에 대한 관리체계 개선, 의료전문가 제도 내 연령통합관련 커리큘럼 포함, 노인전문 의료서비스와인력양산 그리고 노인과 노인대상 의료영역에 대한 인식개선을 제안하였다.

• 디지털융복합연구
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• 제15권10호
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• pp.513-524
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• 2017

본 연구는 심리치료학과와 경찰학과 대학생을 대상으로 범죄피해케어전문가과정(CVCS)의 융합 교과목 및 교육과정을 개발하는 것이다. 이를 위하여, 첫째, 전국 심리학과/상담학과/심리치료학과/경찰학과/경찰행정학과 교과목과 교육과정을 조사하여 양 학과의 교과목 목록을 작성하고, 양 학제의 교수진의 자문을 받아 교육과정모형안과 3단계별 교과목 목록안을 선정하였다. 둘째, 현장맞춤형 교과목/교육과정을 개발하기 위해, 전국 51명의 범죄피해지원기관의 피해자지원/상담/심리치료 전문가들 대상, 적합도와 중요도를 델파이 설문조사하였다. 도출한 최종교육과정은 기본과정, 기초과정, 심화과정으로서 기초과정은 부전공, 심화과정은 복수전공의 학제에 따라 교과목 수를 편성하였다. 기본과정은 각 학과별 5개의 교과목으로 구성되고 기초과정은 7과목, 심화과정은 4과목을 선정하였다. 마지막으로 향후 연구에 대한 논의와 함의를 제안하였다.

• Journal of Oral Medicine and Pain
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• 제26권4호
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• pp.309-318
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• 2001

The purposes of the study were (1) to evaluate the olfactory identification ability in those who have bad breath, (2) to determine the olfactory detection threshold for methyl mercaptan in normal subjects and those who have bad breath, and (3) to evaluate the effect of oral hygiene care on the olfactory detection threshold for methyl mercaptan. Sixteen male subjects with bad breath (male odor group), 9 male subjects without bad breath (male non-odor group), and 10 female subjects without bad breath (female non-odor group) were included for the study. Olfactory identification ability was assessed by administrating the Cross-Cultural Smell Identification Test (CC-SIT), and the olfactory detection threshold for methyl mercaptan was measured by two-alternative forced-choice single-staircase detection threshold procedure in a double-blinded condition. The geometric mean of the last four staircase reversal points of a total of seven reversals is used as the threshold. For the male odor group, after 1 month of intensive oral hygiene care for reducing oral volatile sulfur compounds (VSC) concentration, the olfactory detection threshold for methyl mercaptan was measured again and compared to the initial value. The ANOVA was used to test the group difference of olfactory threshold and olfactory identification ability and the paired t-test was used to test the difference of olfactory threshold between before and after reduction of oral VSC in male odor group. The results were as follows : 1. There was no significant difference in olfactory identification ability among those who have bad breath and normal male or female subjects. 2. The olfactory detection threshold for methyl mercaptan was about 8.4 ppb in normal male and female. 3. There was a tendency that male subjects with bad breath showed a higher olfactory detection threshold for methyl mercaptan when compared to those of no bad breath. 4. The olfactory detection threshold for methyl mercaptan returned to a normal level after 1 month of intensive oral hygiene care for reducing oral VSC.