• Journal of Trauma and Injury
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• 제18권1호
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• pp.1-16
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• 2005

An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.

• Parasites, Hosts and Diseases
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• 제44권3호
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• pp.221-228
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• 2006

We conducted a study to compare the safety and tolerability of anti-relapse drugs elubaquine and primaquine against Plasmodium vivax malaria. After standard therapy with chloroquine, 30 mg/kg given over 3 days, 141 patients with P. vivax infection were randomized to receive primaquine or elubaquine. The 2 treatment regimens were primaquine 30 mg once daily for 7 days (group A, n = 71), and elubaquine 25 mg once daily for 7 days (group B, n = 70). All patients cleared parasitemia within 7 days after chloroquine treatment. Among patients treated with primaquine, one patient relapsed on day 26; no relapse occurred with elubaquine treatement. Both drugs were well tolerated. Adverse effects occurred only in patients with G6PD deficiency who were treated with primaquine (group A, n = 4), whose mean hematocrit fell significantly on days 7,8 and 9 (P= 0.015, 0.027, and 0.048, respectively). No significant change in hematocrit was observed in patients with G6PD deficiency who were treated with elubaquine (group B, n = 3) or in patients with normal G6PD. In conclusion, elubaquine, as anti-relapse therapy for P. vivax malaria, was as safe and well tolerated as primaquine and did not cause clinically significant hemolysis.

• Safety and Health at Work
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• 제1권1호
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• pp.19-28
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• 2010

Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.179-183
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• 1984

Tetracyclines복용으로 유발된 것으로 생각되는 약제성 식도궤양 3예를 보고하고 관계문헌의 내용을 고찰하고 비교해 보았다. 갑작스런 흉골하 작열감, 상복부 불쾌감 및 연하통을 호소할 때는 약제에 의한 식도궤양을 생각해보고 더 많은 관심을 가지고 내시경검사를 시행하면 쉽게 진단할 수 있을 것으로 생각되어지나, 병력과 문진으로도 대개 진단할 수 있다. 또한, 식도궤양을 유발할 수 있는 약물의 capsule이나 정제를 투약할 때는 복용방법과 시각에서, 약이 씻겨 내려갈 정도의 충분한 양의 액체를 같이 복용하도록 하고 잠자리 들기 바로전의 시각은 피하여 복용한 후 약이 내려갈 정도의 충분한 시간동안 눕지 않도록 권유하면 쉽게 예방할 수 있을 것으로 생각된다.

• 한국병원경영학회지
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• 제24권2호
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• pp.12-22
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• 2019

Purposes: The purpose of this study was to examine the association between risk behaviors and smoking in Korean adolescents. Methods: This study used data from online survey of youth health behavior in 2017. Data from a total of 54,411 people (27,139 male, 27,272 female) were included in the analysis. chi-square test, simple logistic regression, multiple logistic regression were performed using SAS 9.4. Findings: Multiple logistic regression analysis showed that risk behaviors such as drinking alcohol experience, sexual experience, drug use experience and high caffeine energy drinks intake experience had a significant effect on smoking. Adolescents with drinking experience were more likely to smoking than those who had no experience(OR=8.58, 95% CI: 7.67~9.60). Adolescents with sexual experience were more likely to smoking than those who had no experience(OR=4.47, 95% CI: 3.91~5.11). Adolescents with drug use experience were more likely to smoking than those who had no experience(OR=2.32, 95% CI: 1.63~3.32). Also, adolescents with high-caffeine energy drinks intake experience were more likely to smoking than those who had no experience(OR=1.37, 95% CI: 1.23~1.53). Practical Implications: All the risk behaviors were significantly associated with smoking rates. Results of this study suggest that physicians and health workers in medical institutions and health centers should simultaneously serve education and consultation for the smoking cessation as well as for the prevention of risk behaviors.

• 보건행정학회지
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• 제34권2호
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• pp.120-128
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• 2024

2024년 2월부터 현재까지 의과대학 입학정원 확대를 두고 논란이 계속되고 있다. 이런 논란은 현재와 미래의 시점의 문제가 혼합되어 논란을 더 가중하고 있다. 현시점에서 의사의 인력부족 여부에 대한 논란은 다양하다. 동일한 근거가 의사 부족 또는 부족하지 않은 근거로 제시되기도 한다. 부족하다는 근거로 제시하는 것에 대해서도 이견이 많으며 그 반대의 근거도 이견이 많다. 현시점에서 의사 부족 여부를 둘러싼 이런 논란은 합의될 가능성이 그리 크지 않다. 10년 후에는 노인인구의 급격한 증가로 인해 의사가 더 필요하게 될 것이므로 의과대학 입학인원을 늘려야 할 것이다. 그러나 그 숫자는 의학교육의 질이 저하되지 않을 수준이어야 한다. 이를 위해 의학교육의 질이 높은 의과대학에 더 많은 입학인원을 배정해야 하며, 그 대안으로 대규모 의과대학은 입학인원을 20%-30% 늘리고, 소규모 의과대학은 입학인원을 40%-50% 늘리면 전체 증가인원은 760-1,066명이 되는 것이다. 2,000명 증원이 강행된다면 의학교육의 질을 면밀히 평가해 그 결과를 의과대학 정원 조정에 반영해야 할 것이다. 20년 후에는 의과대학 입학정원을 줄여야 한다. 이는 의사공급이 1차함수로 증가할 것인데 반해 의사수요(의료수요)가 꼭지점이 있는 2차함수로 변화하고 있기 때문이다. 현재의 인원을 유지하더라도 2048년부터는 의사가 과잉되기 때문에 의과대학 입학인원을 줄여야 하며, 규모는 현재보다 1,000명이 적은 2,000명 정도로 축소해야 할 것이다. 정원 축소 시 모든 의과대학에 일률적으로 축소한다면 소규모 의과대학이 많아지기에 M&A (mergers and acquisitions) 전략을 적용해야 할 것이며, 그 대상은 40개의 의과대학과 12개의 한의과대학이어야 할 것이다. 우리나라의 경우 의사수요 추정에 가장 큰 영향을 미치는 요인은 인구 변화이다. 합계출산율의 급격한 감소로 인해 향후 인구 전망은 불확실성이 상당 수준 있으며, 최근 의료이용률의 급격한 증가가 반영된 수급추계는 재검토되어야 한다. 의사 수급추계의 불확실성으로 인해 의사 수급추계는 최소한 5년 단위로 지속적으로 실시되어야 하며, 이를 위해 보건의료인력검토위원회를 설치 운영해야 한다.

• 대한한방내과학회지
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• 제33권3호
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• pp.298-305
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• 2012

Objectives : This study was aimed to promote the cooperative system of Korean and Western medicine in the dual health care system through a survey of physicians on recognition, problems and solution of the cooperative system. Methods : The research took place at Dongguk University Hospital from May 25 to 27, 2009 with 44 professors, residents, and interns employed by the hospital. Results : Of total 44 surveyed doctors, positive and moderate responses on the cooperative system between Korean and Western medicines were 40.9% and 43.2%, respectively. They scored it positive (62.5%) and moderate (31.3%) based on their experiences. These results can be supposed to represent the environment for the interdisciplinary medicine. Even in the interdisciplinary hospital of Korean and Western medicine, 68.2% of responders had no experience of the cooperative medical system. Expected interdisciplinary efficient departments were ordered rehabilitation medicine, neurology and orthopedics and associated with musculoskeletal disorders, the most frequent diseases treated by Korean traditional medicine. Conclusions : Korean and Western medical doctors, as medical personnel, intellectual persons as well as specialists, need a recognition and attitude to understand and respect each others' medicine. However, both groups also realize there are many complicated issues in the treatment of patients. It is difficult to require a change of Western doctors' perceptions and attitude toward Korean traditional medicine only with results of a survey. For the efficient cooperative system in the medical field, Korean medical doctors will need to study and consider specific problems mentioned by Western medicine.

• 한국컴퓨터정보학회논문지
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• 제10권4호
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• pp.29-36
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• 2005

컴퓨팅 환경이 보다 발전함에 따라 병원에서 환자 회진 및 진찰시 PDA나 랩탑 및 타블렛 PC등과 같은 post PC를 이용한 보다 적용적이고 지능화된 서비스가 요구되어진다. 본 논문에서는 의료 환경을 위한 음성 서비스 기반의 상황인식 지원 시스템을 설계 및 구현한다. 이를 위해, 먼저 블루투스 무선 통신 기술을 이용하여 이동성을 지닌 PDA를 소유한 클라이언드를 인식하고, 컨텍스트 서버로부터 환자들을 위한 진단 정보 전송과 같은 해당 클라이언트의 컨텍스트에 적합한 실행 모듈을 실행하는 역할을 담당하는 컨텍스트 미들웨어를 제안한다. 아울러, 사용자의 현재 상태, 물리적 환경, 컴퓨팅 시스템의 리소스 등의 상황 정보를 효율적으로 데이터베이스 서버에 저장하는 관리자의 역할을 수행하는 컨텍스트 서버를 기술한다. 마지막으로, 제안하는 시스템의 유용성을 검증하기 위해, 컨텍스트 미들웨어를 통해 다른 의사들에게 해당 환자의 정보를 통보할 수 있는 음성 재생 서비스를 제공하는 응용 시스템을 개발한다.

• 한국산학기술학회논문지
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• 제16권9호
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• pp.6160-6168
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• 2015

의료기관 종사자의 손 위생 수행은 의료관련 감염의 전파를 예방하는 가장 효과적인 방법이다. 본 연구는 직종별 손 위생 수행 측정과 분석을 위해 세계보건기구(WHO)의 손 위생 수행 평가도구를 이용한 직접관찰방법으로 2010년 10월 25일부터 12월 31일까지 수행되었으며, SPSS 21.0으로 기술분석, 교차분석, 다중로지스틱분석을 하였다. 총 8,644 건의 손 위생 상황이 관찰되었고, 손 위생 수행률은 94.1%였으며 의사가 가장 낮았다(83.3%; OR:0.209, 95%CI:0.174-0.252). 직종별 수행률(p<0.001), WHO에서 권고하는 5개 상황(WHO's 5Moments)별 수행률은(p<0.001) 유의한 차이를 보였으며, 간호사(p=0.003)와 의료기사직(p<0.001)이었다. 본 연구결과 손 위생 수행률 향상을 위한 직종별 특성화된 손 위생 전략과 WHO's 5Moments에 따라 차별화된 전략 개발이 필요할 것으로 사료된다.

• 한국보건간호학회지
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• 제15권1호
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• pp.182-201
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• 2001

This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.