• 한국병원경영학회지
• /
• 제6권1호
• /
• pp.120-146
• /
• 2001

This study was carried out to provide the essential information in improving the graduate medical education in Korea. For the study, a survey targeting the directors of GME of nationwide teaching hospitals was performed with a questionnaire asking the questions such as the director's perception on the quality of GME, trainees' salary level, trainees' specialty selection tendency, training system and its duration. The collected data were analyzed using t-test, ANOVA, and $x^2$-test. The results were as follows: 1. The survey were executed on 240 teaching hospitals in Korea and the response rate was 66.2% (159 hospitals replied). 2. The bigger a hospitals is the better in Quality of education. Larger hospitals tend to have better status in all items including medical specialists' experience, contents of medical curriculum, general environment for medical education and medical trainees's salary level. The result supported the general perception on the positive relationship between hospital size and Quality of GMA. 3. Providing convenience for medical trainees who prepares for the medical specialist Qualifying examination didn't affect the results of the examination. 4. The directions of GME have a perception that the trainees give positive impact on financial performance of their hospitals. This seems to be one of the reasons that hospitals try to retain as many trainees as possible. 5. The directors of GME considered medical trainees as an educate, and most of them responded positively on the need of governmental supports for the education cost and the trainee's salary. Considering above results, it seems that GME would get more social attention and the trainees' impact on hospitals operation would be increased more than before. In response to these trends, hospitals would find out the ways to lower dependency on trainees, and this change of attitude of hospitals on the GME would cause problems in operation of hospitals and GME itself. In order to prevent these problems the policy on GME should be directed in following ways. 1. The contents of Qualifying examination for specialist should be improved. 2. The curriculum of GME should be strictly followed. 3. The status of trainee in a hospital has to be defined as eductee. 4. Government has to support a half of the education cost and salary of trainee. 5. The distribution of the trainee among the hospital group have to be based on total available. 6. The financial support and welfare of trainee should be improved gradually and systematically.

• 한국임상수의학회지
• /
• 제28권6호
• /
• pp.586-590
• /
• 2011

5 kg 미만의 소형견 3마리가 호흡곤란과 심잡음을 주증상으로 내원하였다. 한 마리 환자에서는 일차 심방중격결손과 함께 유미흉이 진단되었다. 나머지 두 마리 환자들에서는 이차 심방중격결손이 확인되었으며, 이 중 한 마리의 환자에서는 폐동맥 협착증이 병발되었다. 내과적 치료를 시도하였으나, 이차 심방중격 결손을 가진 두 마리의 환자들은 폐사하였으며 일차 심방중격 결손이 있는 환자는 약물치료로 성공적으로 유지되었다. 폐사한 두 마리의 환자에 서는 부검을 통하여 결손부를 확인하였다. 본 증례의 경우, 세 마리의 소형견에서 발생한 다양한 해부학적, 혈역학적, 병태생리학적 타입의 심방중격 결손의 임상증상, 진단학적 특징을 대형견에서의 특징과 비교 분석한 첫 증례보고이다.

• 한국의사학회지
• /
• 제30권2호
• /
• pp.119-131
• /
• 2017

GogeumGyeongheomHwalyubang [古今經驗活幼方] is a medical book dedicated to Smallpox, written by YU Sang [柳瑺] in the Joseon Dynasty (late 17th century to the early 18th century). As a smallpox specialist for the Joseon royal family, YU Sang was well-reputed after successfully treating smallpox of three of the 27 Joseon kings. There are four features of this book. First, the causes for smallpox are roughly recorded. Second, YU Sang emphasized the distinction between patients who could or could not be cured. Third, the herbs related to the treatment of smallpox are selected and organized separately. Fourth, YU Sang discusses the contents of diverse medical books and his own experiences. Conclusion : YU Sang's significant knowledge of smallpox treatment is well presented in his book, GogeumGyeongheomHwalyubang and this wealth of experience would have an important role in understanding the development of smallpox treatment in the late Joseon Dynasty.

• 한방안이비인후피부과학회지
• /
• 제19권2호
• /
• pp.168-179
• /
• 2006

Background and Aim : As the aged society is coming, people pay attention to it and the government is also increasing subsidy into the welfare of the aged. As a branch of social welfare, community welfare is familiar and close to local residents. We could open up a new field in community welfare for oriental medicine and oriental medical doctor(OMD). Materials and Method : Analyzing the worts of community welfare center, we tried to find ways for OMDs to take part in there. We focused m community care and home care service of community welfare center and community health center. Result : Free oriental medical services are offered in many places, but a lot of them are temporary and hard to continue due to financial problem and lack of specialist. Local residents want to know about oriental medicine but few OMDs are willing to participate, thereforen, unqualified lectures of such as hand acupuncture, moxibustion, meridian massage prevail among them. This leads to illegal oriental medical services in the name of volunteer medical work. Conclusion The system is needed that local OMD association take part in community welfare of oriental medical service and care with community welfare center and community health center. Local volunteer medical services and researches of medical policy can help increase the chance for OMDs to go into social welfare system of the aged.

• 한국의사학회지
• /
• 제26권2호
• /
• pp.99-110
• /
• 2013

The purpose of this study is to investigate the life and achievements of a doctor whose name is Baek Kwang-hyeon. He was at first a soldier and later became a doctor. After years of practicing, he was chosen as a acupuncture specialist doctor of Royal Office of Medicine. He was also chosen as a Royal doctor. The method to do this study was to read the book "Jisagongyousa Bukyunghumbang(知事公遺事 附經驗方)", which is writing about his life and medical achievements. Also "Seongjeongwon Ilgi(承政院日記)" was searched to find more about Dr. Baek's life. The results were as follows. More unknown records about his life and works could be found. His medical achievements and originality could also be clarified. Through above books and other records, the annual report of his life could be presented at the end of this stuy.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권7호
• /
• pp.3595-3600
• /
• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• 간호행정학회지
• /
• 제13권4호
• /
• pp.537-545
• /
• 2007

Purpose: The purpose of this study was to compare the role and the certification system for nurses working in HIV/AIDS care among the U.S., the UK, and Japan. Method: The searching for the internet website and literature was used and visiting the institutes and interviewing the key informants were done from August, 2006 to February, 2007. Results: In the U.S., there are two types of nurse specialist in HIV/AIDS care. One is the HIV/AIDS Certified Registered Nurse which is without any academic degree requirement, and the other is the Advanced HIV/AIDS Certified Registered Nurse which requires master level degree and 5 years career. There are three level of nurses' role in HIV/AIDS care in the UK. Also, the National HIV Nurses Association of the UK developed generic competencies and specialist competencies according to this three level of nurse's role. In the case of Japan, the certification system is not formalized yet, but the AIDS coordinator nurses are working as a specialist in the Japan International Medical Center. Conclusion: Based on this result, it is suggested that the comprehensive role of nurses in HIV/AIDS should be developed under the governmental support.

• 한국임상수의학회지
• /
• 제28권4호
• /
• pp.449-451
• /
• 2011

1.28 kg, 수컷, 13살의 붉은귀 거북이(red-eared slider, Trachemys scripta elegans)가 한 달 간의 식욕 부진, 운동성 감소, 전지 부종 및 발적을 주증으로 내원하였다. 고요산혈증과 함께 방사선 앞발가락과 손목 관절의 비투과성 을 동반한 골융해 소견을 보이는 토피성 통풍(tophaceous gout)이 방사선 검사 상에서 확인되었다. Allopurinol (20 mg/kg, 경구, 하루 한 번)과 u/d (Hill's diet)를 처방하였으며 다른 소염제나 항생제는 투여하지 않았다. 내원 한달 후, 거북이의 임상 증상과 방사선 소견은 호전된 양상을 보여주었다. 약물 반응에 따라, 거북이는 관절 통풍으로 추정 진단되었으며 allopurinol은 거북이의 관절 통풍에 효과적임을 보여주었다.

• 한국임상수의학회지
• /
• 제27권2호
• /
• pp.175-178
• /
• 2010

5년령의 수컷 코커스파니엘견이 갑작스런 발작증상으로 내원하였다. 내원당시 중등도의 탈수, 과다유연이 관찰되었고, 의식이 소실된 상태였다. 신체검사상 상복부에서 복강내 종괴가 촉진되었고, 실험실 검사에서 저혈당증과 간효소 수치의 상승이 관찰되었다. 진단으로는 병력, 임상증상, 신체검사, 신경검사, 기본적 실험실 검사와 방사선 검사 및 세포검사가 이용되었다. 특히 원발성 간 선암종이 의심되어 혈청 중 alpha-fetoprotein (AFP)을 측정하였다. 혈청 중 AFP 수치는 특이적으로 정상견에 비해 매우 높은 수준이었다(1513.5 ng/ml). 이 환축은 원발성 간 선암종이 의심이 되었으며 이로 인한 저혈당으로 발작증상을 관리하기 위해 포도당투여를 포함한 약물치료가 시작되었다. 하지만, 보호자의 요청에 의해 안락사가 실시되었고 부검 후 조직 검사를 통하여 원발성 간 선암종으로 확진되었다. 결론적으로 본증례의 경우 개에서 원발성 간암의 진단에 혈청 중 AFP 측정이 진단에 유용할 수 있음을 보여주는 증례다.

• Journal of Preventive Medicine and Public Health
• /
• 제29권2호
• /
• pp.279-294
• /
• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.