• 의료법학
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• 제22권1호
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• pp.57-90
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• 2021

의료인이 직접 환자를 진료하는 형태의 원격진료가 현행 의료법에서 허용이 되는지 여부와 의료법상 허용을 떠나 정책적으로 허용하는 것이 바람직한지의 문제가 오랫동안 논란이 되어 왔다. 그러다가 코비드19라는 인류가 드물게 겪는 팬데믹 상황으로 인하여 우리나라에서 한시적으로 허용이 되었고 외국에서도 이용이 폭발적으로 증가하면서 다시 관심을 받고 있다. 원격진료의 허용 여부에 관하여는 이미 많은 논문이 존재하지만, 막상 원격진료가 실시될 경우 그에 수반되어 발생할 수 있는 부수적인 법적 쟁점들에 관하여는 논의가 부족했던 부분이 있어 이 글에서 다루었다. 필자는 국민건강보험의 수가정책, 환자 본인 확인, 의약품 비대면 구매, 진료장면 녹화에 관하여는 입법적으로 미리 정비를 하는 것이 바람직하다고 보았고, 원격진료에 필요한 시설 기준은 오히려 법제화를 하면 현실에 뒤떨어지거나 변화에 대응하는 탄력성이 떨어지므로 법제화를 하지 않고 대신 의료인이 의료기기법상 승인을 받은 원격진료용 기기를 사용하는 것으로 충분하다고 판단하였으며, 끝으로 원격진료의 맥락에서 발생한 의료사고의 책임이라든가 개인정보 보호는 기존의 민사법이나 개인정보 보호법으로 이미 충분한 대응이 되므로 별도의 특칙을 제정할 필요는 없다는 결론을 내렸다.

• Korean Journal of Acupuncture
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• 제29권1호
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• pp.57-70
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• 2012

Objectives : The purpose of this study is to assess Traditional Korean Medicine (TKM) doctors' awareness and utilization of the case report, based on the opinion that careful observation on the case sometimes provides us with the important information as clinical trial especially in the traditional medicine research field. Methods : A questionnaire study was conducted among TKM doctors who participated in the annual continuous maintenance education (CME) held at 5 regions of the Republic of Korea. Results : Almost 60% of the respondents had read case reports published in medical journals and 67% had openly shared their clinical cases with their colleagues. Of the respondents, 18.6% had been educated on reporting cases, and only 16% had the experience of reporting cases on one's own. However, 32.6% of the respondents had the intention to report cases in the future. These results show significant differences between general physicians who holds a license but no hospital training experience and board certified TKM doctors who have training experience. Conclusions : A majority of TKM doctors have read case reports but holds little experience of having been properly trained. Through this research, it has been found that awareness of case reports is rising in hospital training. Thus, the objective of case report education for TKM doctors who have hospital training experience should be set on encouraging them to do more whereas for doctors without hospital training experience, the objective should be set on making them more exposed to case reports to heighten one's awareness.

• 한국한의학연구원논문집
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• 제16권1호
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• pp.43-50
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• 2010

Background : The varieties of manifestations referred to headache and vertigo have been long complicated physicians in the efficient diagnosis and treatment of these diseases. Objectives : Establish a distinctive and efficient acupuncture method for the treatment of headache and dizziness based in literature research. Method : We reviewed four Korean medical literature, "治腫指南Guide to Swollen Sore Treatment", "東醫寶鑑Treasured Mirror of Eastern Medicine", "鍼灸經驗方Experiential Prescriptions of Acupuncture and Moxibustion", and "舍岩鍼法Essential Rhymes on Acupuncture and Moxibustion by Master Sa-am", and analyzed the therapeutic characteristics in the treatment of headache and vertigo. Result : 1. "治腫指南Guide to Swollen Sore Treatment" inserted needle in GV20百會 and waited until the skin erupts and heat burns, then applied in those regions affected. 2. "東醫寶鑑Treasured Mirror of Eastern Medicine" mostly applied moxibustion on headache, however, needling acupoints such as GV20百會, GV24神庭, GV23上星, GV22顖會 were also considered important. 3. "鍼灸經驗方Experiential Prescriptions of Acupuncture and Moxibustion" used moxa cones on headache in order to disperse heat and direct Gi downward. 4. "校勘 舍岩道人鍼法Essential Rhymes on Acupuncture and Moxibustion by Master Sa-am" defined the cause of dizziness, wood excavates earth and earth kills water. Conclusions : After previous study on eye, oral, glottal, labial, dental diseases and stroke, we could also find various efficient methods according to headache and vertigo, through literature research of Korean medical classics. This study will concurrently result in establishing distinctive therapeutic method characteristic of Korea.

• Journal of Photoscience
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• 제2권1호
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• pp.37-45
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• 1995

INTRODUCTION : Psoralens are planar tricyclic furocoumarins present in numerous plants and fungi found throughout the world.' Naturally occurring and synthesized psoralen derivatives(see Figure 1) are photosensitizers of UVA especially from 320 nm to 400 nm, a range at which cellular nucleic acids and proteins are weakly absorbing if any at all. Because of their skinphotosensitizing properties, these compounds have been used in the photochemotherapy of psoriasis and vitiligo. However, undesirable side effects such as carcinoma development in hairless mice as well as possible liver damage from the use of 8-methoxypsoralen(8-MOP) have been reported. The other photobiological effects include inactivation of DNA viruses, killing and mutagenesis of bacteria, inhibition of tumor transmitting capacity of various cells, and hyperpigmentation on human and guinea pig skin. PUVA(psoralen+UVA) photochemotherapy is in fact thousands of years old, having been used in Egypt and India since B.C. 1200-2000. Photochemotherapy for a common disfiguring disease, vitiligo, was practiced in the ancient world by physicians and herbalists who used boiled extracts of the fruits of certain umbelliferous plants, e.g. Ammi majus Linnaeus in Egypt or the leguminous plants, Psoralea corylifolia L. in India. It was first described by Kuske in 19388 that photosensitization of skin by plants was related to the presence of psoralen. He identified natural psoralens in plants as photosensitizers and isolated bergapten(5methoxypsoralen) from the oil of bergamot. The scientific interest in photosensitizing psoralens, however, has grown considerably after the introduction into clinics of the psoralen photochemotherapy for the treatment of psoriasis and of other skin (abbreviation)

• 보건행정학회지
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• 제24권2호
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• pp.164-171
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• 2014

Background: Safety of drugs has become a major issue in public healthcare. Spontaneous reporting of adverse drug reaction (ADR) is the cornerstone in management of drug safety. We aimed to investigate the awareness and knowledge of spontaneous ADR reporting in general public of Korea. Methods: A total of 1,500 study subjects aged 19-69 years were interviewed with a questionnaire for their awareness and knowledge related to spontaneous ADR reporting. Computer assisted telephone interview was performed from 27th February 2013 to 4th March 2013. Target population was selected with quota sampling, using age, sex, and residence area. Healthcare professionals such as physicians, pharmacists, and nurses were excluded. The survey questions included awareness of spontaneous ADR reporting, opinions on ways to activate ADR reporting, and sociodemographic characteristics. Results: Overall awareness of spontaneous ADR reporting system was 8.3% (${\pm}2.53%$) among general population of Korea. Major source from which people got the information regarding ADR reporting was television/radio (69.9%), followed by internet (19.3%), and poster/brochure (6.1%). Awareness level differed between age groups (p<0.0001) and education levels (p<0.0001). Upon learning about the ADR reporting system, 88.5% of study subjects agreed on the necessity of ADR reporting system, while 46.6% thought promotion through internet and mass media as an effective way to activate ADR reporting. Conclusion: The overall awareness of spontaneous ADR reporting should be enhanced in order to establish a firm national system for drug safety. Adequate promotions should be performed targeting lower awareness groups, as well as various publicity activities via effective channels for the general population.

• 동의생리병리학회지
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• 제23권2호
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• pp.499-504
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• 2009

The purpose of this study was to evaluate the diagnostic indicators which are used for the identification of fire-heat pattern in stroke patients. For evaluation of diagnostic indicator, we analyzed the indicators which are composed of symptoms and signs collected from stroke patients based on the clinical records using case report form (CRF). Patients had a first-ever stroke within 1 month after the onset of stroke. Pattern identification was performed and decided by two independent physicians. Two patient groups that consist of fire-heat pattern and the other patterns were compared to isolate important indicators affecting the fire-heat pattern identification of stroke patients. The 8 indicators among 16 fire-heat pattern indicators were significantly more frequent compared with non fire-heat pattern group. Logistic regression analysis revealed that 5 indicators among fire-heat indicators were significantly sensitive indicators being capable of identification of fire-heat pattern. But two of them was from the indicators of dampness-phlegm pattern and yin deficiency pattern. Therefore, further studies are required for the development of Korean standard indicators of Fire-heat pattern identification.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.9-17
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• 2017

Purpose : The easiest and most cost-effective way to prevent medical-related infections is known as proper hand washing of health care workers. The experience of MERS in domestic medical institutions has increased the importance of hand hygiene for medical workers to prevent infections in hospitals. It is necessary to investigate the level of hand hygiene practice by type of medical institutions and the factors influencing the infection prevention. Methods : Domestic and overseas hand hygiene related business cases and literature data were collected and analyzed in order to investigate the hand hygiene status of medical institutions in Korea. Result : As a result of hand hygiene monitoring of all hospital-level medical institutions in 2016, the total number of observations was 24,328 and the hand hygiene performance rate was 75.9%. The hand hygiene performance rate of hospitals was 71.5% for general hospitals, 75% for general hospitals, and 81.3% for hospitals. Implications : In general hospitals and hospitals, the HR(Hand Rubbing) method is preferred as a way of performing hand hygiene, whereas the HW(Hand Washing) method is relatively high in the small hospitals. It is estimated that the HW system is preferred because of the cost burden at the hospital medical institution. Therefore, it is necessary to compensate the related expenses to improve the hand hygiene performance of the physicians who are engaged in the hospitals.

• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.139-142
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• 2011

Background: Lung cancer is responsible for substantial proportions of cutaneous metastasis from internal malignancies. The aim of this study was to evaluate the clinical manifestations and outcomes of cutaneous metastasis in Korean lung cancer patients. Methods: On a retrospective basis, we analyzed medical records of all patients diagnosed with lung cancer from 2000 to 2006. Results: Cutaneous metastases were found in 10 of 4,385 patients. The number of cases was highest for squamous cell carcinoma. However, there was no metastasis from 754 cases of small cell carcinomas. Cutaneous metastasis was detected during staging work-up in 4 patients and it was the presenting sign of recurrence post-operative in 2 patients. Average time from the diagnosis to discovery of cutaneous metastasis was 16.3 months and median survival was 8.5 months (range, 1.8~19.1 months). Conclusion: Physicians should be acquainted with clinical manifestations and outcomes of cutaneous metastasis from lung cancer to detect new, recurrent cancer, or disease progression, and to administer appropriate and prompt management.

• Archives of Plastic Surgery
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• 제47권2호
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• pp.118-125
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• 2020

Since April 2015, post-mastectomy breast reconstruction has been covered by the Korean National Health Insurance Service (NHIS). The frequency of these procedures has increased very rapidly. We analyzed data obtained from the Big Data Hub of the Health Insurance Review and Assessment Service (HIRA) and determined annual changes in the number of breast reconstruction procedures and related trends in Korea. We evaluated the numbers of mastectomy and breast reconstruction procedures performed between April 2015 and December 2018 using data from the HIRA Big Data Hub. We determined annual changes in the numbers of total, autologous, and implant breast reconstructions after NHIS coverage commenced. Data were analyzed using Microsoft Excel. The post-mastectomy breast reconstruction rate increased from 19.4% in 2015 to 53.4% in 2018. In 2015, implant reconstruction was performed in 1,366 cases and autologous reconstruction in 905 (60.1% and 39.8%, respectively); these figures increased to 3,703 and 1,570 (70.2% and 29.7%, respectively) in 2018. Free tissue transfer and deep inferior epigastric perforator flap creation were the most common autologous reconstruction procedures. For implant-based reconstructions, the rates of directto-implant and tissue-expander breast reconstructions (first stage) were similar in 2018. This study summarizes breast reconstruction trends in Korea after NHIS coverage was expanded in 2015. A significant increase over time in the post-mastectomy breast reconstruction rate was evident, with a trend toward implant-based reconstruction. Analysis of data from the HIRA Big Data Hub can be used to predict breast reconstruction trends and convey precise information to patients and physicians.

• Journal of Trauma and Injury
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• 제31권1호
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.