• Journal of Digital Convergence
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• v.14 no.6
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• pp.325-333
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• 2016

This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

• Clinical and Experimental Pediatrics
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• v.55 no.8
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• pp.286-292
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• 2012

Purpose: Continuous renal replacement therapy (CRRT) is becoming the treatment of choice for supporting critically ill pediatric patients. However, a few studies present have reported CRRT use and outcome in neonates weighing less than 3 kg. The aim of this study is to describe the clinical application, outcome, and complications of CRRT in small neonates. Methods: A retrospective review was performed in 8 neonatal patients who underwent at least 24 hours of pumped venovenous CRRT at the Samsung Medical Center in Seoul, Korea, between March 2007 and July 2010. Data, including demographic characteristics, diagnosis, vital signs, medications, laboratory, and CRRT parameters were recorded. Results: The data of 8 patients were analyzed. At the initiation of CRRT, the median age was 5 days (corrected age, $38^{+2}$ weeks to 23 days), and the median body weight was 2.73 kg (range, 2.60 to 2.98 kg). Sixty-two patient-days of therapy were reviewed; the median time for CRRT in each patient was 7.8 days (range, 1 to 37 days). Adverse events included electrolyte disturbances, catheter-related complications, and CRRT-related hypotension. The mean circuit functional survival was $13.9{\pm}8.6$ hours. Overall, 4 patients (50%) survived; the other 4 patients, who developed multiorgan dysfunction syndrome, died. Conclusion: The complications of CRRT in newborns are relatively high. However, the results of this study suggest that venovenous CRRT is feasible and effective in neonates weighing less than 3 kg under elaborate supportive care. Furthermore, for using potential benefit of CRRT in neonates, efforts are required for prolonging filter survival.

• Journal of Korean Academy of Nursing
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• v.24 no.2
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• pp.190-205
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• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.191-202
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• 1985

As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.

• Journal of Sasang Constitutional Medicine
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• v.25 no.1
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• pp.23-33
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• 2013

Objectives This study was aimed to develop the clinical practice guidelines, which focuses on Sasang Constitutional Medicine symptomology. By developing clinical practice guidelines, we should present prevention, diagnosis, treatment and assessment of Sasang Constitutional Medicine. Methods We used the method of University of Michigan Health System Guidelines model. Electronic databases including English, Korean databases were systematically searched for clinical articles investigating Sasang Constitutional Medicine symptomology up to March 2010. And "Donguisusebowon-ShinChukbon" was basically used to develop clinical guidelines. Results and Conclusions 12,694 Articles were reviewed. Only 25 articles described adequate methods of this study. Using clinical practice guidelines, we can manage th quality of medicine, emphasis treatment appropriacy and educate patients and doctors. Finally We can get the Sasang Constitutional Medicine standardization and socioeconomic benefit.

• The Journal of Advanced Prosthodontics
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• v.7 no.6
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• pp.468-474
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• 2015

PURPOSE. The aim of this study was to characterize and compare bacterial diversity on the removable partial denture (RPD) framework over time. MATERIALS AND METHODS. This descriptive pilot study included five women who were rehabilitated with free-end mandibular RPD. The biofilm on T-bar clasps were collected 1 week ($t_1$) and 4 months ($t_2$) after the RPD was inserted ($t_0$). Bacterial 16S rDNA was extracted and PCR amplified. Amplicons were cloned; clones were submitted to cycle sequencing, and sequences were compared with GenBank (98% similarity). RESULTS. A total of 180 sequences with more than 499 bp were obtained. Two phylogenetic trees with 84 ($t_1$) and 96 ($t_2$) clones represented the bacteria biofilm at the RPD. About 93% of the obtained phylotypes fell into 25 known species for $t_1$ and 17 for $t_2$, which were grouped in 5 phyla: Firmicutes ($t_1=82%$; $t_2=60%$), Actinobacteria ($t_1=5%$; $t_2=10%$), Bacteroidetes ($t_1=2%$; $t_2=6%$), Proteobacteria ($t_1=10%$; $t_2=15%$) and Fusobacteria ($t_1=1%$; $t_2=8%$). The libraries also include 3 novel phylotypes for $t_1$ and 11 for $t_2$. Library $t_2$ differs from $t_1$ (P=.004); $t_1$ is a subset of the $t_2$ (P=.052). Periodontal pathogens, such as F. nucleatum, were more prevalent in $t_2$. CONCLUSION. The biofilm composition of the RPD metal clasps changed along time after RPD wearing. The RPD framework may act as a reservoir for potentially pathogenic bacteria and the RPD wearers may benefit from regular follow-up visits and strategies on prosthesis-related oral health instructions.

• Journal of radiological science and technology
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• v.25 no.2
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• pp.57-64
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• 2002

The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS(Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented considerations in the process of development. So we have developed MIH(Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. This program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development or the program which refers to the medical +ata quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that tile program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images.

• Korean Journal of Microbiology
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• v.54 no.3
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• pp.188-199
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• 2018

Genomic epidemiology exploits various basic microbial research areas. High-throughput sequencing technologies dramatically have been expanding the number of microbial genome sequences available. Abundant genomic data provide an opportunity to perform strain typing more effectively, helping identify microbial species and strains at a higher resolution than ever before. Genomic epidemiology needs to find antimicrobial resistance genes in addition to standard genome annotations. Strain typing and antimicrobial resistance gene finding are static aspects of genomic epidemiology. Finding which hosts infected which other hosts requires the inference of transient transmission routes among infected hosts. The strain typing, antimicrobial resistance gene finding, and transmission tree inference would allow for better surveillance of microbial infectious diseases, which is one of the ultimate goals of genomic epidemiology. Among several high-throughput sequencing technologies, genomic epidemiology will benefit from the more portability and shorter sequencing time of the Oxford Nanopore Technologies's MinION, the third-generation sequencing technology. Here, this study reviewed computational methods for quantifying antimicrobial resistance genes and inferring disease transmission trees. In addition, the MinION's applications to genomic epidemiology were discussed.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.9 no.11
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• pp.1015-1026
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• 2019

The purpose of this study is to develop evaluation indexes for improving the quality of long-term care institutions (facility salary) evaluation in the sense that the applicability and effectiveness of previous studies related to the development of evaluation indexes for long-term care facilities for elderly are insufficient. There was this. To this end, an analytical review of the 2018 long-term care institution (accommodation benefit) evaluation index, an analysis of Japan's elderly long-term care home evaluation index, and the elderly long-term care facility workers in Korea and the special care home for the elderly in Japan FGI on evaluation indicators and evaluation system was conducted. Based on the results of the research, evaluation indicators were developed in terms of supporting users to receive high quality services. The characteristics of the elderly, that is, the characteristics of elderly diseases that are difficult to maintain and improve, the direction and transparency of institutional operation, and the need for terminal care were reflected. Forty-three evaluation indicators were presented, covering institutional operations, environment and safety, beneficiary rights protection, payroll process, and payroll results. In addition, we proposed a four-step multi-level evaluation system that can improve the efficiency of the evaluation process by improving the redundant and unnecessary evaluation process.

• The Korean Society of Law and Medicine
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• v.21 no.3
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• pp.3-33
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• 2020

Telemedicine can be defined as "medical activities performed remotely by medical personnel using information and communication technology." So far, many scholars in Korea have understood that only telemedicine between medical personnel is allowed and telemedicine between medical personnel and patients is prohibited based on Article 34 of Medical Service Act. However, Article 34 is only a restriction on the performing place of medical profession, not a prohibition on telemedicine itself. And, there are no regulations prohibiting telemedicine under the korean medical law. So, it is difficult to say that telemedicine is generally prohibited under the korean medical law, apart from the health insurance medical treatment benefit standards. However, there is controversy in interpretation regarding the meaning of "direct diagnosis" in Articles 17 and 17-2 of Medical Service Act. The Constitutional Court of Korea interpreted this as "face-to-face diagnosis", while the Supreme Court of Korea interpreted it as "self diagnosis". In light of the dictionary meaning of 'direct' and the interpretation of related medical law regulations, I think the Supreme Court's interpretation is valid. Although "direct diagnosis" does not mean "face-to-face diagnosis", the concept of "diagnosis" implies "principle of face-to-face diagnosis". In addition, "non-face-to-face diagnosis" are only allowed to supplement "face-to-face diagnosis", so the problems caused by "non-face-to-face diagnosis" can be fully overcome. In the end, the limit of telemedicine is how faithful the diagnosis was.