• 구강회복응용과학지
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• 제38권2호
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• pp.110-119
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• 2022

부분 무치악 환자의 가철성 국소의치 수복 시 지대치가 항상 유리한 위치에 존재하지는 않는다. 이로 인하여 잘 맞게 제작된 가철성 국소의치임에도 불구하고 환자는 가철성 국소의치의 안정과 지지에 대하여 만족하지 못하는 경우가 발생하게 된다. 이 때, 소수의 임플란트 크라운을 이용한 가철성 국소의치가 부분 무치악 환자에게 좋은 대안이 될 수 있다. 소수의 임플란트를 위치시키고 지대치로 이용하여 가철성 국소의치의 안정과 지지를 증가시킬 수 있다. 본 증례는 하악 편측에 잔존치를 갖는 환자에서 두개의 임플란트를 전략적으로 위치시켜 지대치를 양측으로 분포시켰다. 최종 가철성 국소의치 수복 이후 환자는 저작 기능에 만족감을 보였으며 국소의치 사용시 편안함을 나타내었다.

• 대한방사선기술학회지:방사선기술과학
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• 제11권2호
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• pp.27-64
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• 1988

Most hospital administrators in our country have doubted whether or not the size of their hospital personnel staffs, and the personnel management styles implemented are efficient or not. Actually, increased personnel expenditures due to sophisticated specialization of medical practices has become the biggest hospital expense. Therefore, it is said that hospitals can be run move efficiently by implementing reasonable management strategies for hospital personnel management. In this paper, the departments of diagnostic radiography in 16 general hospitals in Seoul, which were classified into 4 groups by the scale of hospital beds, were used as sample cases. Then, the data for the number of X-ray examination by diagnostic item was collected from sample hospitals. The unit hour spent on X-ray examinations in each diagnostic service was quoted from "A Study on setting-up of the relative value units of medical services and on the structure of current fee schedules" written by Mr. Ik Je Seong. The data analysis results are as follows; First, the number of hours per day spent on X-ray examinations in 13 hospitals out of 16 hospitals, was shorter than the general daily working hours (8 hours). Second, in the morning there was not enough time to work for X-ray examinations required, with the available manpower. In the afternoon, however, the situation was diametrically opposed to that in the morning. Third, in light of above results, though most hospitals employ sufficient personnel for the quantity of the actural work, they were always short-handed where their works were performed Fourth, this study tells us that there is a maldistribution of the work in the schedule : too much work for the available personnel in the morning. The following recommendations are resulted from the data analysis described above. First, it is recommended that all out-patients coming again, except specific patients(G. B. or I.V.P. etc) who have to have their X-ray examinations on an empty stomach in the morning among out-patients, be required to visit the hospital in the afternoon. Second, it is recommended that all new out-patients be required to make a reservation in order to equalize the number of patients throughout the day. Third, it is recommended that all in-patients, except specified patients, be arranged to have their X-ray examinations in the afternoon. Fourth, it is recommended that part time workers be employed during peak hours. This recommendation, if applied in a wider scale, would allow hospitals to overcome the problem of the maldistribution of work and personnel, and then more efficient hospital management through the appropirate personnel management procedures could be expected.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.11-24
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• 1996

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

• 보건행정학회지
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• 제24권4호
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• pp.367-379
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• 2014

Background: Over the last decade, medical tourism industry has grown in Korea. Especially the number of Mongolian medical tourists has increased rapidly. Therefore, the Mongolia is one of the targets for Korea medical tourism. The purpose of this study is to investigate the effects of destination image and expected attributes of medical services on Mongolian's intention to use Korean medical tourism service. Methods: This study empirically collected survey data from Mongolian lived in Mongolia. The study analyzed the data using a PLS model. Results: Our results are as follows. First, the country image didn't significantly have causal effects on expected medical service quality and perceived risk. Second, tourism image (e.g., entertainment, economic feasibility, and local convenience) has significantly causal effects on expected medical service quality and perceived risk. However, tourist site as tourism image didn't significantly have causal effects on expected medical service quality and perceived risk. Third, medical image made a statistically significant effect on expected medical service quality and perceived risk. Fourth, the expected medical service quality showed a significant effect on intention to use Korean medical tourism service. Fifth, the perceived risk of medical tourism showed a significant effect on the reliability of medical tourism, but didn't show a significant effect on the intention to use Korean medical tourism service. Finally, the reliability has a significant effect on the intention to use Korean medical tourism service. Conclusion: From our empirical results, this study concluded that as a strategy attracting Mongolian patients, it is more effective to strengthen Korean hospital image and tourism image than Korean country image.

• 한방안이비인후피부과학회지
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• 제30권3호
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• pp.20-30
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• 2017

Background : Tinnitus is common disorder with many possible causes and a symptom of many different diseases but has no effective treatment. Approximately 20% of tinnitus patients experience the disorder to a degree that their quality of life and productivity are impaired. Objectives : 1. Through symptoms of tinnitus, we tried to find out the relationship of Heo-sil(虛實) and Jang bu byun jeung(臟腑辨證). 2. By testing THI, we tried to evaluate the quality of life between high-grade tiny noise and low-grade roar tinnitus patients group. Methods : 34 patients were recruited in this study who was ill with tinnitus. They wrote out the questionnaire about tinnitus and the tinnitus Handicap Inventory(THI). Results : 1. The vast majority of high-grade tiny noise patients are Heojeung(虛症). 2. The vast majority of low-grade roar patients are Siljeung(實症). 3. The number of patients with intermittent and persistent tinnitus is similar. 4. In high-grade tiny noise, Sin jung hyu son type(腎精虧損型) patients are less comfortable with quality of life than Bi wi heo yak type(脾胃虛弱型) patients. 5. Low-grade roar patients are less comfortable with quality of life than high-grade tiny noise atients Conclusions : Jang bu byun jeung(臟腑辨證) and Distinguishing between Heo(虛) and Sil(實) is expected to have positive effects on tinnitus treatment.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.115-122
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• 2015

Purpose: To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator. Methods: The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25. Results: The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%. Conclusion: PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.74-80
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• 2006

Purpose: For prevention and suitable administration, the effect of age on the severity of injuries in traffic accidents should be considered when evaluating a patient, but there have not been enough epidemiological studies that evaluate the age factor in traffic accidents. For that reason, we investigated old-aged patients who were involved in traffic accidents (65 years old or more) and who were admitted to the emergency department of a college hospital in an urban city of Korea. Methods: We collected data from traffic-accident patients who came to the emergency room of a university hospital in Seoul from Jan.1, 2004 to Dec.31, 2005. We compared their abilities to ambulate and the RTSs (Revised trauma scores) by using a LSD (least significant difference), linear regression. Results: A total of 1460 patients were included. The mean RTS of all traffic-accident patients was $7.77{\pm}0.280$. The scores for drivers and passengers, motor-cycle drivers and passengers, bicycle drivers and passengers, and pedestrians were $7.79{\pm}0.21$, $7.78{\pm}0.22$, $7.54{\pm}0.25$, $7.77{\pm}0.20$, and $7.80{\pm}0.21$ respectively (p=0.000). There was no statistically significant difference between the RTS of patients over 65 years and that of other patients. In a regression analysis, the number of patients over 45 ages who were able to ambulate was lower than that of younger people, independently of other influencing factors (B=-0.330, R-square = 0.243, p=0.000). Conclusion: We expected that RTS of old age group more than 65 years old will significantly lower than that of others, but there was no statistically significant difference.

• 호스피스학술지
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• 제2권1호
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

• 대한산업공학회지
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• 제36권1호
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• pp.59-68
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• 2010

The medical emergency departments are suffering from the crowdness of patients, hence the quality of medical service the patients are receiving are getting poorer. Overcrowding of medical emergency departments may incur the waiting time for the treatment, and the improper treatment in time. For the operational control of the emergency department, the crowding index is commonly used to identify the crowding intensity, with which the operation process is managed, and future process can be expected. In this study the composite crowding index is suggested, in which the trend of inpatients rate, the age and acuity of patients, and resource of ED are considered. The validity of the suggested crowding index is discussed by the regression analysis for the index and the actual number of inpatients, and by the simulation study using the process model and the real data.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 춘계학술대회
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• pp.411-412
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• 2022

최근 들어 잘못된 보행 습관과 신발 착용으로 족부 질환자들이 늘어나고 있다. 신발의 발달과 생활환경으로 누구나 족부질환으로부터 안심할 수 없다. 족부질환 환자가 정형 신발 구매시 신발디자인 특성이 만족도와 구매 의도에 어떠한 영향을 미치는지 연구한다. 신발 디자인 특성은 기능성, 편의성, 심미성으로 구성하였다. 사회활동 참여 빈도, 착용 목적, 족부 질환별 상태와 특징 등 다양한 관점에서 연구된다. 연구 결과를 통해 정형 경증 족부질환 환자들이 일상생활에서 유용하게 착용할 수 있는 정형 신발 디자인 개발과 현실적인 활용과 만족으로 이어지길 기대한다.