• Safety and Health at Work
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• 제3권4호
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• pp.243-256
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• 2012

This article schematically reviews the clinical features, diagnostic approaches to, and toxicological implications of toxic encephalopathy. The review will focus on the most significant occupational causes of toxic encephalopathy. Chronic toxic encephalopathy, cerebellar syndrome, parkinsonism, and vascular encephalopathy are commonly encountered clinical syndromes of toxic encephalopathy. Few neurotoxins cause patients to present with pathognomonic neurological syndromes. The symptoms and signs of toxic encephalopathy may be mimicked by many psychiatric, metabolic, inflammatory, neoplastic, and degenerative diseases of the nervous system. Thus, the importance of good history-taking that considers exposure and a comprehensive neurological examination cannot be overemphasized in the diagnosis of toxic encephalopathy. Neuropsychological testing and neuroimaging typically play ancillary roles. The recognition of toxic encephalopathy is important because the correct diagnosis of occupational disease can prevent others (e.g., workers at the same worksite) from further harm by reducing their exposure to the toxin, and also often provides some indication of prognosis. Physicians must therefore be aware of the typical signs and symptoms of toxic encephalopathy, and close collaborations between neurologists and occupational physicians are needed to determine whether neurological disorders are related to occupational neurotoxin exposure.

• Journal of Medicine and Life Science
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• 제16권3호
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• pp.76-79
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• 2019

Korean Physicians encounter often the patients with cultural syndromes. This paper surveys those cultural syndromes in Korea, contrasted with those in other countries in five different domains; socio-cultural, sexual, psychological, psychosomatic and religio-spiritual. I discovered three natural consequences if not intervened; 1) healed and readjusted, 2) paradigmatically shifted for the better results and 3) mal-adjustment for the worse. In the hope to let the culture shifted toward better one, I propose to allow our Koreans to be educated, inspired by Park Wansoe's novel; 'Dreaming in an Incubator(꿈꾸는 인큐베이터)'.

• Journal of Preventive Medicine and Public Health
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• 제25권4호
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• pp.357-373
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• 1992

After medical insurance came into effect in Korea, health care system has undergone tremendous changes. Changing patterns of newly established clinics is one of them. To investigate changes and trends, a total of 10,184 clinics which were newly established from 1981 to 1990 were analysed. Data were obtained from the file of contracting medical facilities of the Federation of Medical Insurance Societies. The proportion of newly establishied clinics has increased gradually, so that they amount to 13% of the total medical facilities in Korea. Meanwhile, the number of newly established medium-size hospitals and general hospitals have decreased. The number of newly established clinics per 100,000 populations has increased in the all areas, but the rate of increase has decreased in the cities except in 6 major cities in 1990. The rate of increase in newly established clinics surpasses that of population increase. This study has identified the trend of young physicians' early driving into their solo medical practice than before. This indicates chance of the medical specialty training nowadays toughen due to the limited openings in residency programs. However, the sex ratio of physicians at newly established clinics has not changed. The decreasing tendency to open medical practice without beds and the increasing size of clinics are found in this study(The size has been measured in terms of medical manpower, of beds, and of medical equipment in this study). Two thirds of general practitioners have opened their clinics without beds, although such trend has been less in the case of specialists. All three indicators show increasing size, especially in the case of rural clinics. However, among them, the number of medical equipments has increased most significantly from 8.9 items in 1981 to 12.9 in 1990.

• 한국모자보건학회지
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• 제21권3호
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• pp.159-165
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• 2017

The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.

• Journal of Preventive Medicine and Public Health
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• 제55권3호
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• pp.226-233
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• 2022

Objectives: The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments. Methods: This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being. Results: In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%). Conclusions: The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.

• Journal of Preventive Medicine and Public Health
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• 제48권6호
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• pp.271-273
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• 2015

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.

• 한국지능시스템학회논문지
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• 제21권4호
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• pp.456-462
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• 2011

최근 미국의 경기부양 법안이 통과됨에 따라 전 세계적으로 의료 산업분야에서의 EHR 시스템에 대한 관심이 증대되고 있다. 이 법안은 다양한 의료표준을 통해 상호 운용성을 보장하는 EHR 시스템을 도입하는 의원이나 병원에 인센티브를 제공하는 프로그램을 제시하고 있다. 이러한 인센티브 프로그램으로 인해 많은 EHR 시스템이 개발되었고, 또한 많은 의원이나 병원이 CCHIT에서 인증한 EHR 시스템을 도입하고 있다. 미국 의료 산업의 변화에 발맞추어 국내의 일부 기업에서도 국내병원에 EMR 시스템을 구축한 경험을 바탕으로 미국 의료 시장에 진출하려고 노력하고 있다. 그러나 미국과 한국의 의료 환경이 상이하여 개발한 시스템의 개선이 불가피하다. 따라서 본 논문에서는 의료표준화 기술에 기반하여 서로 다른 의료정보 시스템 간의 상호 운용성을 보장하는 통합형 EHR 플랫폼을 설계하고 개발한다. 개발한 플랫폼에서는 전송 표준 및 방법, 용어 표준 및 활용, 의사 결정을 위한 지식 관리 등의 다양한 기반 기술을 통합하여 완성된 하나의 시스템을 구현하였고, 의료정보의 표준화를 위한 표준용어체계와 의료정보의 교환을 위한 HL7 인터페이스 엔진을 탑재하여 의료 데이터의 전자적 처리가 가능하도록 하였다. 개발한 플랫폼에 기반하여 미국 개원의의 외래 진료를 지원하기 위한 EHR 시스템인 SeniCare를 개발하고, CMS에서 제시한 "의미 있는 사용"의 조건의 부합 여부를 확인함으로써 개발한 플랫폼의 효용성을 검증한다.

• 대한영상의학회지
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• 제81권5호
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• pp.1024-1037
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• 2020

상대가치란 소모된 자원의 양을 기준으로 의료행위의 가치를 상대적으로 비교한 점수로 의사업무량, 진료비용, 위험도로 구성된다. 2차 상대가치 개정 당시 영상검사 수가는 높은 원가 보존율을 이유로 인하되었다. 영상검사 수가는 상대가치 체계에서 진료비용이 대부분을 차지하고 있으며, 의사업무량은 상대적으로 저평가되어 있다. 문재인케어라고 불리는 새로운 건강보험 보장성 강화 대책은 비급여의 급여화, 본인부담금 상한제 확대, 재난적 의료비 지원을 골자로 국민의 의료비 부담을 줄이는 것이 목표이며 향후 건강보험 재정에 부담이 늘어날 것으로 우려된다. MRI와 초음파 검사 급여 확대는 문재인케어에서 큰 비중을 차지하고 있으며 영상의학과는 문재인케어 적용 과정에서 저평가된 영상검사에서의 의사의 노동을 적절히 평가받을 수 있도록 노력해야 한다.

• 대한수혈학회지
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• 제23권2호
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• pp.97-106
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• 2012

The Korean Society of Blood Transfusion (KSBT) was established in Seoul in 1982 by a group of physicians of clinical pathology (currently laboratory medicine), internal medicine, paediatrics, anaesthesiology, and surgery, who were members of the Korean Society of Hematology, in which they had been actively engaged as transfusion specialists. However, these physicians were dissatisfied with the lack of public recognition of blood transfusion and the unrealistic blood service system and therefore attempted to build an influential organization for improvement of blood services and transfusion medicine. The mission of the KSBT is to advance the science and practice of transfusion medicine. The KSBT advocates for education and research in the fields of transfusion medicine and for safe blood in blood services. The inaugural KSBT conference, with approximately 50 participants, was held in November, 1982; since then, annual conferences and educational workshops have been held regularly once or twice a year. Currently, the KSBT has approximately 800 members, who are practitioners of blood transfusion (holders of M.D.) or staff members of blood services (holders of other professional degrees). The Society also publishes the Korean Journal of Blood Transfusion (first issue published in 1990) and guidelines for blood services. A Society web site (http://www.transfusion.or.kr) was started in 2001, with the hope of increasingly providing information and feedback to members on a real-time basis. The KSBT has been an active participant in international activities. In 1995, the KSBT hosted the Sixth ISBT Western Pacific Regional Congress in Seoul and will host the $33^{rd}$ ISBT Congress in Seoul in 2014. Since its inauguration, the KSBT has had key roles not only in education and research in the fields of transfusion medicine but also in development of safe-blood services during the last 30 years.

• 한국콘텐츠학회논문지
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• 제13권3호
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• pp.240-250
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• 2013

자살 생각을 초기에 발견하는 것은 자살을 예방하는 데 중요하다. 본 연구는 의료 현장에서 사용될 수 있는 간단한 스크리닝 도구를 개발하는 것을 목적으로 하였다. 자살위험 스크리닝 도구는 의사들이 빠르고 쉽게 사용할 수 있도록 설계되었다. 미국 알래스카 Norton Sound region의 Screening for Depression and Thoughts of Suicide라는 도구로부터 2개의 항목으로 구성된 스크리닝 도구를 만들었다. 이 도구는 개인식별번호를 제외하는 등 한국의 실정에 맞게 양식이 수정되었으며 한국형 자살위험 스크리닝 도구로 이름붙였다. 이 도구의 신뢰성과 적용가능성은 7명의 의사들을 통해 검토되었다. 이 도구의 타당성은 4개의 의료기관에서 325명의 환자들을 조사하여 현재의 정신건강 상태를 외부 기준으로 하여 확인하였다. 이와 같은 2개 문항으로 구성된 자살위험 스크리닝 도구는 정신과 의사 및 기타 의사들에 의해 환자의 자살경향을 발견하는데 사용될 수 있을 것이다.