• Journal of Chest Surgery
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• 제33권1호
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• pp.79-84
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• 2000

Background: Esophageal perforation is an extremely lethal injury that requires careful management for survival,. Material and Method: We performed a retrospective clinical revi-ew of 14 patients treated for esophageal perforation at the Department of Thoracic and Cardiovascular Surgery hanyang University Hospital between July 1986 and August 1998. Cardiovascular Surgery Hanyang University Hospital between July 1986 and August 1998. Result: The ration between male and female patients was 12:2 and their ages ranged from 9 to 68 years( average: 446 years). Iatrogenic perforations were found in 6 patients(42.9%) spontaneous perforations in 3 patients(21.4%) traumatic perforations in 2 patients(14.3%) and caustic perforations foreign body origin and esophagel cancer in 1 patient (7.1%) each. Four of the patients(28.6%) had esophageal ruptures located cancer in 1 patient (7.1%) each. Four of the patients (28.6%) had esophageal ruptures located in the cervical esophagus and 10 patients (71.4%) in the thoracic esophagus, The most frequent location was in the mid third portion of the esophagus (35.7%) there were also 2 patients(14.3%) in the upper third portion and 3 patients(21.4%) in the lower third portion. Complications encountered included mediastinitis empyema or pleural effusion mediastinal or lung abscess sepsis and aspiration pneumonia. The most frequent complication that occurred was mediastinitis in 9 cases (57%) Three patients underwent conservative treatment. Among the patients who underwent surgical treatment 5 patients underwent primary closure 6 patients underwent open drainage and 2 patients underwent reconstrumction (1 patients had an initial primary closure and 1 patient had an initial open drainage procedure). The mortality rates for those with conservative and surgical treatment were 66.7% (2cases) and 9.1% (1 cases) respec- tively. Conclusion: Perforation of the esophagus although very rare has a high mortality rate and thus aggressive operative therapy is necessary.

• 한국방사선학회논문지
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• 제15권7호
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• pp.1021-1030
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• 2021

국내 결핵 환자 관리의 방안을 모색하고 결핵 정책의 기초자료를 제공하고자 2010년부터 2018년까지 통계청과 질병관리본부의 결핵 환자 통계 연보와 세계보건기구(WHO; World Health Organization)의 GLOBAL Tuberculosis Report 등의 자료를 수집하여, 국내 결핵 환자 현황을 분석하였다. 결과는 다음과 같다. 첫째, 국내 결핵 환자 발생 현황 결과는, 2018년 33,796명(65.9%), 신환자는 2018년 26,433명(51.5%)으로 약 21.3% 감소한 것으로 나타났다. 둘째, 국내 결핵 환자치료 현황은 과거 치료결과 불명확은 2018년 655명으로 2014년 대비 약 160% 증가한 것으로 나타났다. 셋째, 청소년 결핵환자 발생률은 10에서 14세는 2018년 1.8%, 15세에서 19세는 15.0%로 고등학생의 결핵 발생률이 높았다. 넷째, 나이별 결핵 환자 발생률을 보면 60대 이상의 대상자가 60% 이상의 결핵 유병률을 보였으며 특히 80세 이상의 노인결핵 환자가 증가하였다. 다섯째, 성별 결핵 환자발생률 현황은 2010년 대비 2018년에 남성이 여성보다 1.4배가 많은 것으로 나타났다. 여섯째, 전국적으로 결핵 유병률은 전남 1,419명(75.6%)이 가장 높았고, 세종 99명(33.4%)이 가장 낮았다. 일곱째, 국내 외국인 환자 수는 2012년 1,510명으로 지속적으로 늘어나 2016년에는 2,569명으로 증가한 것으로 나타났다. 이상의 결과에 따라 결핵 재발자, 고등학생, 60세 이상의 연령층, 80세 이상의 노인, 군대 등의 남성 집단, 외국인 대상의 신속하고 정확한 결핵 조기 검진정책과 관리가 필요하다.

• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.197-205
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• 2019

The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.61-67
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• 2011

Purpose: Lawn trimmers are widely used to cut the weeds around graves in South Korea, but they can cause ocular injury. We investigate at the emergency room the incidence and the clinical features of ocular trauma induced by lawn trimmers. Methods:The authors analyzed 106 patients who visited Konyang University Hospital's emergency room from March 1, 2007, to October 31, 2011, because of ocular trauma caused by a lawn trimmer. Patients were sorted into two groups, severe ocular injury and mild ocular injury. Results: Over a 5-year period, 106 patients with ocular trauma caused by a lawn trimmer underwent clinical study. Most of the patient (103 patients) were males, and the average age of the patients was $51.75{\pm}11.66$ years. The incidence of ocular trauma peaked in the sixth decade of life. Most injuries occurred between July and September. Severe ocular injury developed in 46.2% of all patients. As age increased, so did the severity of the ocular injury. The impacting object was a small stone in 43.4% of all patients. Nobody wore protective gear. The most common diagnosis were corneal abrasion, followed by intraocular foreign body, corneal laceration, and sclera laceration. Fifty-four patients were followed up, and thirty-six patients of them had severe injury. The most common complication was a traumatic cataract. Conclusion: Ocular trauma induced by a lawn trimmer is more severe than general ocular trauma. We suggest that everyone using a lawn trimmer should wear protective gear and follow safety guidelines.

• 의료법학
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• 제23권1호
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• pp.3-33
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• 2022

원격의료와 관련해서, 우리나라 의료법은 제17조 및 제17조의2와 제34조 규정을 두고 있다. 의료법 제17조 및 제17조의2의 '직접 진찰'은 '대면 진찰'이 아니라 '스스로 진찰'로 해석될 수 있으므로, 위 규정은 원격의료를 금지하는 규정으로 보기는 어렵다. 진찰의 개념이나 '대면진료의 원칙'만으로 원격의료를 금지하는 것은 죄형법정주의 원칙에 위반될 수 있다. 다만, '진찰'에 해당하기 위해서는 대면진찰을 대체할 정도의 충실성이 담보되어야 하므로, 전화를 통한 부실한 진찰 후 진단서나 처방전 등을 발급하는 행위는 의료법에 위반된다고 할 수 있다. 그러한 점에서 보면, 위 규정이 원격의료를 간접적으로 제한하는 규정이라고 할 수 있다. 한편, 우리나라 통설은 제34조를 근거로 의료인과 환자 간 원격의료는 전면 금지된다고 해석하고 있으며, 최근 대법원은 환자의 요청이 있다고 하더라도 이러한 원격의료는 허용되지 않는다고 판시하였다. 그러나, 이러한 해석은 2002년 의료법에 원격의료 규정이 도입될 당시의 입법의도와 상당한 거리가 있을 뿐만 아니라, 현실의 요구나 외국의 입법추세와도 맞지 않는다. 상황이 이렇게 된 이유는, 원격의료 규정이 잘못 입법되었기 때문이라고 생각한다. 입법의 전제가 잘못되었고, 입법의 기술이나 체계, 그 내용에도 상당한 문제가 있다. 그 결과 당초 입법의도와는 달리 원격의료가 전면 금지되는 결과가 초래되고 말았다. 외국에서도 원격의료를 전면금지하고 이에 대해서 형사처벌하는 사례는 찾아보기 어렵다. 원격의료의 문제를 근본적으로 해결하기 위해서는 의료법 제34조를 삭제할 필요가 있다.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.276-292
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• 2018

본 연구는 재난관련 국내외 연구동향을 체계적 문헌고찰 방법을 통해 검토하고 이를 토대로 미래 재난관련 대응과제 및 발전방향에 대한 기초를 설정하기 위해 시도되었다. 관련 문헌검색은 국내외 데이터베이스를 통해 2000년 이후부터 2017년 2월 28일 까지 재난관련 용어를 조합하여 수행되었고, 총 177편의 문헌 중 선택 및 배제기준을 통해 최종 79편의 문헌이 분석에 활용되었다. 연구 결과, 재난관련 연구의 유형은 양적 연구가 31.6%로 가장 많았으며 전공 학문 영역별로는 의학분야에서 수행된 연구가 29.1%로 가장 많았고, 그 외 공학(18.9%), 행정학(13.9%), 간호학(11.4%) 순이었다. 국외의 경우 다중손상사고에서의 환자분류를 위한 트리아제 관련 연구가 많은 반면 국내에서의 트리아제 관련 연구는 전체의 30.4%에 불과하였으며, 대부분 트리아제 개발이나 개발된 트리아제의 효과평가 연구, 트리아제 관련 조사연구, 고찰 등이었다. 또한, 국제간호협회의 재난간호 역량 틀에 따라 분석한 결과, 대응 단계 관련 연구가 72.3%로 가장 많았다. 향후 재난관련 연구는 학제간 융합, 다중손상사고시의 생존율 향상을 위한 환자 분류체계 및 기술 통합 등이 필요하며, 다학제 간 공동연구결과를 기반으로 한 통합시스템이 필요한 것으로 사료된다.

• 한국학교보건학회지
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• 제13권1호
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• pp.131-145
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• 2000

For the purpose of strengthening Dental Hygiene students' confidence and motivation in the Dental Hygiene Department and helping construct proper professionalism, survey on Dental Hygiene students' consciousness of attitude to and satisfaction of the course, career plan and occupation mind set was carried out. 530 three year students in 8 Dental Hygiene academies in Seoul and Kyonggi province were questioned. The results of the survery are as follows:. 1. Dental Hygiene students' motives consisted primarily of employment and a desire for professionalism 25% of them entered the course after one failure in the entrance examination and 17% had family members engaging in the dentistry field 84%, the largest portion, were from an academic high school. 24% had some knowledge of Dental Hygiene, which they had acquired from seniors, friends, and teachers. 2. Patient care and treatment assistance related matters were not considered important in the course. The weak points of the course turned out to be education in computers and foreign languages, but the weakest was the ability of patient care during clinical training. 53% had experiences had thought of changing their major while in the course because it didn't match their aptitude and interest. 3. As for a career after graduation, 49% worried about it Most students wanted to work at a dental hospital or general hospital, The most favored duty was coordination or reception or oral disease preventive work. They wanted to work untill they had a stable living. 68% answered they would get a job at an oral clinic and 70% said they would continue studying for self-realization. 4. Satisfaction with the major was high in students whose aptitude and interest matched the course, who had background knowledge of the major, and who. didn't think of changing the major but would continue studying resulting in statistically slight difference(p<0.001). As to satisfaction with the faculties, it was high in the students whose aptitude and interest matched the major and who didn't think about a career after graduation showing a slight difference(p<05, p<0l). As for satisfaction with clinical training, students whose aptitude and interest matched the major and who didn't consider changing the major answered positively showing a statistically slight difference(p<.001, p<.01). As to satisfaction with the course, it was high in the students who entered with aptitude and interest, who had preliminary knowledge, who didn't consider changing the major, and who didn't think about a career after graduation showing a statistically slight difference(p<.001, p<.05). 5. Occupation mind-set was positive for students who entered with interest and aptitude, who had preliminary knowledge, and who had not considered changing the major showing a statistically slight difference(P<.001). The higher the satisfaction with the major, faculty and clinical training was, the more positive the occupation mind-set was(p<.001).

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권3호
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• pp.7-16
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• 2022

Purpose: This study aims to establish the basic directions of the modular airborne infection isolation(AII) ward. Considering a specific function and purposed use as a modular AII ward, it is a chance to derive an address of current modular technology by overview the limitation and improvement of the existing modular architecture. Methods: In addition to the literature analysis on the configuration system of mobile hospitals, research cases on the operational effectiveness of the domestic and foreign mobile construction systems are analyzed. Results: In order to meet the various and strict space guidelines of the AII ward and a chance to improve limitations of uniformed existing modulars, AII modular the negative pressurized care setting should be minimized a structural restriction for reflecting its system on a architectural plan. For this unique requirements, it could be possible to apply various space boxes called infill box which needs to secure a large-scale space. So, a rahmen structure system could be adaptable for this purpose. A dead space between beams of the rahmen structure is to be used for MEP installation. Partial separation, dismantling, and repair should be possible by separating the MEP and infill box from the structure. The infill box must keep 3.5m width under the current Road Traffic Act. Implications: It is necessary to utilize and develop an improved construction method that can reduce the problems of existing steel modular and PC modular.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.58-61
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• 2018

현재의 한국의 의료 기술은 세계에서 인정받고 있을 만큼 최고의 수준이다. 그에 따라 여러 의사들은 다양한 장애나 질병에 대해 전문적인 지식을 가지고 더 좋은 방법으로 치료를 진행하고 있다. 이렇게 높아지는 의료 기술에 따라 시술이나 수술의 성공확률의 증대와 동시에 환자에게 높은 신뢰성을 제공할 수 있게 되었다. 시술이나 수술 이후에 있을 부작용을 줄이고 빠른 완치를 위해 행하는 재활치료도 의료의 일종이다. 하지만, 이 부분에서의 사정은 조금 다른 점이 있다. 재활에 관련된 기구, 동작 등 개발하려는 움직임은 있으나, 현재는 대부분을 외국에 의존하고 있다. 우리가 흔히 알고 있는 재활치료는 동작에 의한 형태가 주를 이룬다. 하지만, 환자의 증상이 어느 정도인지, 얼마만큼 나아졌는지 알아보는 것 또한 재활의 일종이며, 그 또한 의사가 판단하는 하에 그 지표를 마련하고 있는 실정이다. 본 논문에서는 음식물 삼킴 동작에 문제가 있는 것을 심각 정도에 따라 파악하는 VFSS 검사에 딥러닝을 활용하여 눈으로 보이는 지표를 마련해 프로그램을 개발하는 것을 연구해 보았다.

• 한국병원경영학회지
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• 제21권2호
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• pp.1-12
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• 2016

This study examines academic research trends and the change of patterns by analyzing researches related to hospital management registered in Korea Citation Index(KCI) from 2010 to 2014 and offers basic information for interests and future research demands in the field of hospital management As research subjects, a total of 694 published articles were selected. It's to analyze them by dividing into research topics, methods and author's characteristics, and to present them by classifying the period into 2010-2011, 2012-2013, 3rd quarter of 2014 since there was no significant difference in the result between adjacent years. As a result, Korean Journal of Hospital Management has accounted for the highest published rate year after year. In the research topic analysis, it showed a decreasing trend in these research topics as medical marketing and patient satisfaction which became the biggest issue in 2010-2011 significantly were lower in 2014, but an increasing trend in job satisfaction, job stress, labor administration and workforce productivity. The most frequently cited keywords were hospital employees, job satisfaction, organizational commitment, job stress, turnover intention. According to the research method analysis, the survey was the most popular method for data collection. However, Interview and medical records as data sources showed a decline trend. As analysis methods, multivariate analysis of quantitative methods was most used. Finally, as a result of analyzing main author's characteristics, the ratio of the authors belonging to health administration and nursing departments of the academic world increased gradually. In the regional distribution, organizations in Seoul are most common, those in Daegu Gyeongbuk areas, foreign organizations showed a tendency to decrease. This is the first study to examine the annual trend on hospital management-related research issues among articles published in domestic journal and we found qualitative and quantitative advances in hospital management research filed.