• 대한소아치과학회지
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• 제29권2호
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• pp.237-242
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• 2002

Lowe 증후군 또는 안뇌신증후군(oculocerebrorenal syndrome)은 X-염색체와 관련된 유전성 질환으로 반성열성유전양상을 나타낸다. 선천성 백내장과 녹내장 등의 안 증상, 근긴장 저하 건반사감소 등의 근신경계 증상, 신장 기능이상이 가장 특징적인 임상 증상이며, 이외에도 정신 지체, 성장지연, 전두부 융기, 가늘고 성긴 모발, 돌출된 귀, 골질환 등이 발생할 수 있다. Lowe 증후군 환자는 정신지체로 인해 치과치료시 전신마취하에서의 처치가 요구되나, 대사성 산증, 악성고열의 발생위험과 사용약제에 의한 부작용 등이 위험요소로 작용할 수 있으므로, 필요한 경우 내과 또는 소아과 의료진이 참여된 협진체제 하에서 가능한 짧은 시간 진행되어야 한다. 이러한 치과적 처치의 어려움으로 Lowe 증후군 환자에서 치과질환의 예방이 좀더 강조되어야 하면, 이를 위해 보호자의 주위의 적극적 관리가 요구된다.

• 대한간호학회지
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• 제5권1호
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• pp.31-40
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• 1975

A study on public health education curriculums of 14 universities located in Seoul city was carried out from Oct. 15 1974 to Nov. 15 1974. The data were obtained from 11 universities bulletins & 3 universities administration officers. The contentments of public health were obtained by the interview with the teaching professors on the syllabuses. The results were as follows: 1. General Public health topics were taught at 4 universities (28.6%) out of 14 universities & 129 departments (25.3%) out of 509 departments. General public health education were taught at 2 universities (28.6%) out of 7 universities with medical school of the colleges of education 2 collages (18.2%) had the public health education in the curriculums. 2. Academic administration of Public health education by universities 2 hrs for 2 credits were allocated at 2 universities (50%), while 4 hrs for 2 credits at the rest universities (50% ), Pubic health education were taught as an essential general education at 4 universities. Public health education were taught in freshman course at 2 universities in senior course at 2 other universities. Text books on public health education were chosen at 2 universities and at other 2 universities, just references were introduced to students. Contents of public health education. In two universities teaching programs of public health were undertaken & in other two universities no particular leaching programs were undertaken. And contents of tuberculosis, V. D. & communicable disease control Pregnancy & delivery, precaution ok post paestum maternal & child health were taught at 4 universities. Contents of health & college students, alcohol tobacco & coffee, chosen of sports were taught at few university. 3. General public health education instructors: The instructors were consisted of 13 men(81.2%) & 3 women (18.8%) Physicians were 11 (68.8%), nurses 2 (12.5%) & others 3(18.7%) Full time instructors were 7 (43.7%) part time instructors 9 (56.3%) Position & organization instructors belong to ; instructors (75.0%) had the teaching position in universities & research workers & others were 3 (18.8%) & medical practitioner was I(6.2%) 4. Public health & home nursing education by general home economic departments. Home nursing & public health were taught as an compulsory general education program in 10 departments 50.5% & as an alternative major course in 7 departments (35.0%) 2 hrs for 2 credits were allocated at 9 departments (45.0%) while eve. 4hrs for 4credits were 8 departments (40.0%).

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.5001-5004
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• 2015

The Reid colposcopic index (RCI) helps physicians for interpret the results of colposcopic examination. To compare the accuracy of RCI in colposcopic evaluation between general and oncologic gynecologists, this prospective trial was conducted by invited women over 20 years of age who were scheduled for a colposcopy at Chiang Mai University Hospital between August, 2008 and May, 2014 to participate. Pregnant patients or those having a history of hysterectomy or conization were excluded. During the colposcopy, all patients were simultaneously evaluated by general and oncologic gynecologists utilizing the RCI. Further management with either a biopsy or LEEP in each patient was dependent on the decision of the attending oncologic gynecologist. The accuracy of the RCI in diagnosing HSIL or more was calculated by the comparison with the final histology. Finally, 135 patients were recruited into this study. The sensitivity, specificity, PPV, NPV, and accuracy of RCI in diagnosing HSIL or more in general gynecologists were 45.2%, 80.7%, 41.1%, 83.2% and 72.6% while in the oncologic gynecologists were 51.6%, 85.6%, 51.6%, 85.6% and 77.8%, respectively. The difference in accuracy between evaluator groups was not significant (p-value=0.28). Of 3 patients with invasive cervical cancer, all were undetected by the general gynecologists using RCI while only 1 invasive cervical cancer was missed via RCI by the oncologic gynecologists. We conclude that RCI could be used by general gynecologists in provincial hospitals with major concerns about missing invasive cervical cancer. A short training period regarding colposcopy might help to resolve this problem.

• 의료법학
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• 제19권2호
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• pp.235-261
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• 2018

2016년 12월 20일 신설된 「의료법」 상 설명의무 조항과 관련하여, 시행일(2017. 6. 21)이 일 년여가 지난 지금까지도 그 실효성을 둘러싼 논란이 끊이지 않고 있다. 본 연구에서는 의사 109명을 대상으로 온라인 설문조사를 실시하여 의료현장에서 의사의 설명 의무 이행/미이행 경험과 그에 대한 법적 판단을 확인하고, 「의료법」 개정이 의사의 설명 의무에 관한 법적 인식에 어떠한 영향을 주었는지 분석하고자 하였다. 연구도구는 기존의 한 연구(이윤영, 2004)에서 사용한 도구를 수정·보완하여 총 41개 문항으로 구성되었으며 설명의무에 관한 경험 및 법적 판단 관련 26개 문항, 의료법 개정에 관한 인식 관련 6개 문항, 일반적 특성 9개 문항을 포함하였다. SAS 9.4 통계프로그램을 이용하여 자료를 분석한 결과 「의료법」에 설명의무에 관한 내용이 신설되었다는 사실을 모르고 있는 응답자가 전체의 절반 이상이었으며 대부분의 응답자가 설명의무를 이행하지 못한 경험이 있는 것으로 나타났다. 설명의무의 이행 혹은 생략에 관한 13개 사례에 대해 법적 판단을 물은 결과 응답자별 평균 8개 사례에 대해 옳은 판단을 내렸으며, 옳은 판단을 내린 개수는 응답자의 「의료법」 개정 사실에 대한 인식정도와 통계적으로 유의한 관련성을 찾아볼 수 없었다. 이러한 결과에 비추어 볼 때 공법적 제재만으로는 설명의무에 대한 의사의 인식 및 이행 강화에 충분한 효과를 기대하기 어려우며, 의료체계 내부에서 의료기관의 특성과 의사의 조직문화를 고려한 공신력 있는 설명의무 가이드라인 마련과 설명의무와 그 취지에 대한 의사교육 강화를 제언하는 바이다.

• 보건행정학회지
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• 제19권3호
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.

• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.38-44
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• 2005

Objective : To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. Methods : The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea s National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61,164 medical doctors with a follow-up period of 473,932 person-years. Standardized mortality ratios(SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. Results : We confirmed 1,150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47(95% CI : $0.44{\sim}0.50$). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : $0.38{\sim}0.68$). Conclusions : The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.

• 임상간호연구
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• 제21권2호
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• pp.169-179
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• 2015

Purpose: The purpose of this study was to investigate nurse images and likability that were perceived by various groups in the general population. Methods: Using cross-sectional descriptive design, six groups of people were invited to participate in the survey. The participants included nurses, physicians, nurse aids/technicians, patients/caregivers, college students, and the general public. A total of 1,530 individuals were drawn from 42 hospitals nationwide. Bhargava's likability questionnaires and the Ward Nurse Image tool were used. Results: Compared with other groups, patients and caregivers had higher scores for likability and better nurse image than other groups. Most respondents perceived nurses are clean and caring, but many individuals still had the image that nurses are submissive. Conclusion: To improve nurse image, perceptions from various groups of people need to be considered and programs develop to show the positive aspects of nursing and nurses.

• 의학교육논단
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• 제11권1호
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• pp.11-20
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• 2009

The purpose of this study was to introduce the concepts of experiential learning and the Kolb's model, and to review some applications of experiential learning theory in graduate medical education. The published literature on GME and education for general practitioners applying the experiential theory and the Kolb's model was reviewed. Experience learning defined the cyclical learning process which emphasizes the learners' reflective thinking of the learners' concrete experiences and their active participation in continuous learning actives. Kolb includes this 'cycle of learning' as a central principle in his experiential learning theory. This is typically expressed as a four-stage cycle of learning. Kolb's cycle moves through concrete experience(CE), reflective observation(RO), abstract conceptualization(AC) and active experimentation(AE). Components of continuing education of the adult learner were based on autonomy, context of learning, and competence and performance as educational objectives. Some strategies for graduate medical education were reflective thinking, self-directed learning, morning reporting and feedback with peer review, etc. Opportunities for learning from experience in practical life can be made to enhance reflective thinking and performance of practitioners. Strategies to develop reflective practice among physicians should be explored by further research.

• 한국의사학회지
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• 제25권1호
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• pp.61-69
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• 2012

A growing number of people shows deep interests in healthcare and treatments for the elderly with increasing their population. Contrary to general adults, old people have their own physiological and pathological characteristics. Therefore, treatments for the elderly should be different form those for others in younger generation. Alimentotherapy, which means the treatment or prevention by means of food, is one of the best way to deal with geriatrics that are chronic, multiple. Korea has its tradition and plenty of information in this field. Even in the early ChoSun Dynasty, when people suffered from lack of proper medical care, physicians used dietary prescriptions as active treatments, Therefore, we can find lots of cases in "Hyangyak-jibseogbang" and "Euibangyoochui" which are medical books published at that time. After that, a specialized alimentotherapy book, "Sikryochanyo" was written based on that kind of total medical volumes. With development of society, economy. and medical science, alimentotherapy has grown remarkably. Unlike in the early Chosun Dynasty, it was used positively for promoting general health condition and practiced as supportive method for medication in the late Chosun Dynasty. Considering the characteristics of the elderly, alimentotherapy is the most effective way to keep them healthy and can also used with medication.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1980년도 학술대회지
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• pp.143-150
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• 1980

The purpose of this double-blind study was to study the standardized ginseng-extract (marketed form, GINSANA), in regard to its efficacy on the reaction time, pulmonary function and general health in subjects of various age-groups. The trial was conducted as a double-blind study in a total of 120 subjectsm allocated to different groups, according to age (30 to 39 and 40 to 60 year age-groups), sex and preparation administered (ginseng/placebo). The study lasted 12 weeks and the dosage was fixed at 2 capsules per day. The rusults regarding reaction time and pulmonary function showed significant differences in favour of the GINSANA group, over the placebo group, in the 40 to 60-year-old men and women. In the self-evaluation (performance, mood, concentration) we observed a clear improvement (p < 0.001) in the subjects treated with GINSANA, with the exception of the men age 30-39 years. The results botained, which are specially related to reaction, pulmonary function, self evaluation and tolerability, have shown that GINSANA, as standardized ginseng extract, has a favourable effect on the psychic and physical functions studied. 3. Performance test in top sportsmen before and after 9 weeks' treatment with GINSANA To what extent can GINSANA influence physical performance? It is precisely we the physicians whose task it is to find drugs which in physiological amounts do not have any special pharmacodynamic effects. We were therefore interested in the preparation, GINSANA which was made available to us, since it contains a qualitatively and quantitatively standardized GINSENG EXTRACT and is not doping agent.