• Title/Summary/Keyword: Medical Direction

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A Literature Review of Issues and Tasks by Period of Revision of Regulations Related to Convalescent Rehabilitation Wards in Japan: Focusing on Quality Evaluation

  • Lee, Minyoung;Jeon, Boyoung
    • The Journal of Korean Physical Therapy
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    • v.34 no.1
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    • pp.26-37
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    • 2022
  • Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

Direction Reorganization of Public Health Center Functions through Analysis of Medical Service Status by Public Health Care Institutions (지역보건의료기관의 진료현황 분석을 통한 보건소 기능개편 방향)

  • Park, Sun Hee;Lee, Mee Sun;Oh, Yumi
    • Health Policy and Management
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    • v.32 no.1
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    • pp.3-13
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    • 2022
  • Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

A positive feedback loop of heparanase/syndecan1/nerve growth factor regulates cancer pain progression

  • Xiaohu Su;Bingwu Wang;Zhaoyun Zhou;Zixian Li;Song Tong;Simin Chen;Nan Zhang;Su Liu;Maoyin Zhang
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.60-71
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    • 2023
  • Background: The purpose of this research was to assess the role of heparanase (HPSE)/syndecan1 (SDC1)/nerve growth factor (NGF) on cancer pain from melanoma. Methods: The influence of HPSE on the biological function of melanoma cells and cancer pain in a mouse model was evaluated. Immunohistochemical staining was used to analyze HPSE and SDC1. HPSE, NGF, and SDC1 were detected using western blot. Inflammatory factors were detected using ELISA assay. Results: HPSE promoted melanoma cell viability, proliferation, migration, invasion, and tumor growth, as well as cancer pain, while SST0001 treatment reversed the promoting effect of HPSE. HPSE up-regulated NGF, and NGF feedback promoted HPSE. High expression of NGF reversed the inhibitory effect of HPSE down-regulation on melanoma cell phenotype deterioration, including cell viability, proliferation, migration, and invasion. SST0001 down-regulated SDC1 expression. SDC1 reversed the inhibitory effect of SST0001 on cancer pain. Conclusions: The results showed that HPSE promoted melanoma development and cancer pain by interacting with NGF/SDC1. It provides new insights to better understand the role of HPSE in melanoma and also provides a new direction for cancer pain treatment.

A Literature Review of the East-West Medical Combined Treatment (한양방 병용치료에 대한 문헌고찰)

  • Kim, Chang-Seok;Kim, Sang-Kyun;Kim, Young-Eun;Kim, Chul;Yea, Sang-Jun;Jang, Hyun-Chul;Song, Mi-Young
    • Korean Journal of Oriental Medicine
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    • v.18 no.2
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    • pp.101-116
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    • 2012
  • Objectives : This study aims to analyze the papers of the east-west medical combined treatment and suggest the research direction. Methods : 183 research papers were collected by using 25 keywords including combination(in korean words, 병용), collaborative practice(in korean words, 협진) in Korean Medical Database(KMbase) and Oriental Medicine Advanced Searching Integrated System(OASIS). We analysed the type of studies, the kind of diseases, the treatment method, the kind of herbs and drugs in frequent use, and the result of research. Results : Among the analysed 183 papers, clinical studies are 89 cases and experimental studies are 94. 5 cases of clinical studies are Randomized Controlled Trial(RCT). The cancer(50 papers) and diseases of the circulatory system(25 papers) occupied mostly in treatment studies. Because Combined treatment was actively progressed in oriental medicine, treatment was mainly applied the combined oriental medical treatment with herbs and western drugs. In herbal medicine, Mahwangyounpae-tang(麻黃潤肺湯) and Eunkyo-San(銀翹散) were frequently used in the papers. In western drugs, Cyclophosphamide, Cisplatin, and Mitomycin C were frequently used in the papers. 154 papers introduced the treatment effect, 14 papers announced the safety, and 4 papers mentioned the side effect. Conclusions : We suggested several future research direction as follows. Clinical studies based on experiment studies must be more activated and many RCT shoud be shown. Experimental group in clinical studies should be clearly separated to confirm the treatment method is effective or isn't effective. Studies about the side effect must be expanded, and every study should be confirmed both the treatment effect and safety.

The statistical analysis for cognizance on the Chinese oriental medical doctor of the pulse meter-analyzer (중의사의 맥진기 인식에 대한 통계 분석 연구)

  • Kim, Gyeong-Cheol;Kim, Jong-Hwan;Shin, Woo-Jin;Lee, Hai-Woong;Park, Ju-Yeon;Hong, Sang-Min;Doo, Seung-Hee;Kang, Hee-Jung;Yingri, Zhao
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.13 no.2
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    • pp.88-116
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    • 2009
  • Background : EBM (the evidence based medicine) is the direction of the development for oriental medicine. The pulse meter-analyzer is the important part to standardize the pulse diagnosis. When we set up the direction of the study on the pulse meter-analyzer, the awereness about the pulse meter and analyzer of the clinical oriental medical doctors as consumers is very important. Objectives : In order to prepare for the mutual study and the export strategy on the pulse meter-analyzer of Korea and China, the attitude of the study and the grasp of the awereness about the pulse meter-analyzer of the Chinese medical doctors are very important. Methods : We developed the several items as the important factor of the development of the pulse meter and analyzer. They were translated by chinese medical doctor. The investigation for demend was conducted during 3 months in Guangzhou City, Guangdong Province, China. The results of the investigation was done the statistical method of frequency analysis, Chi-squared test, correspondence analysis. Results : The most important differentiation of symptom is the symptom of JANG-BU(臟腑). The method of the utility in the pulse diagnosis is Chon-Gu (寸口) pulse diagnosis and the research on Chon-Kwan-Cheok(寸關尺) is the most important measurement factor. And the typical the old pulse is the little-fine weak pulse. The pulse meter-analyzer is most suitable to the diagnosis of the hypertension and the arteriosclerosis. Conclusion : The development of the pulse analyzer including the requests of Korean and Chinese medical doctors is very important. Specially the researches on the influence factors of the traditional diagnosis and the environment of the measurement are important for developing the pulse analyze.

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Comparison of Cervical Flexor Muscles Thickness During Cranial-Cervical Flexor Exercise According to Pressure Levels and Eye Directions in Healthy Subjects

  • Chang, Jong Sung;Lee, Jeon Hyeong
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.50-54
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    • 2015
  • Purpose: The purpose of this study is to investigate differences of cervical flexor muscle thickness (i.e., sternocleidomastoid muscle and deep cervical flexor muscles) depending on levels of pressure bio-feedback unit and eye directions during cranial-cervical flexor exercise in healthy subjects. Methods: A total of 30 subjects (12 males and 18 females) who had no medical history related to musculoskeletal and neurological disorders were enrolled in this study. They were instructed to perform cranial-cervical flexion exercise with adjustment of five different pressures (i.e., 22 mmHg, 24 mmHg, 26 mmHg, 28 mmHg, and 30 mmHg) using a pressure biofeedback unit, according to three different eye directions (i.e., $0^{\circ}$, $20^{\circ}C$, and $40^{\circ}C$). Muscle thickness of sternocleidomastoid muscle and deep cervical flexor muscles was measured according to pressure levels and eye directions using ultrasonography. Results: In results of muscle thickness in sternocleidomastoid muscle and deep cervical flexor muscles, the thickness of those muscles was gradually increased compared to the baseline pressure level (22 mmHg), as levels in the pressure biofeedback unit during cranial-cervical flexion exercise were increasing. In addition, at the same pressure levels, muscle thickness was increased depending on ascending eye direction. Conclusion: Our findings showed that muscle thickness of sternocleidomastoid muscle and deep cervical flexor muscles was generally increased during cranial-cervical flexion exercise, according to increase of eye directions and pressure levels. Therefore, we suggested that lower eye direction could induce more effective muscle activity than the upper eye direction in the same environment during cranial-cervical flexion exercise.

The Effect of Additional Haptic Supplementation on Postural Control During Squat in Normal Adult (추가적인 햅틱적용이 정상 성인의 스쿼트 동안 자세조절에 미치는 영향)

  • Kim, Mi-Ju;Lee, Ho-Cheol;Park, Ji-Won
    • The Journal of Korean Physical Therapy
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    • v.24 no.2
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    • pp.134-142
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    • 2012
  • Purpose: This study examined the effect on postural control during the stimulation of haptic touch with fingertip on the stable surface at quiet standing posture, squat flexion stage, 60 degrees squat stage and squat extension stage. Methods: The postural sway was measured on the force platform, while 30 subjects were squatting, under three different haptic touch conditions (No Touch [NT], Light Touch [LT], Heavy Touch [HT]), above the touch pad in front of their body midline. Three different haptic touch conditions were divided into 1) NT condition; squatting as right index fingers held above the touch pad, 2) LT condition (<1N); squatting as the touch pad was in contact with right index fingers pulp with a pressure not exceeding 1N and 3) HT condition; squatting as subjects were allowed to use the touch pad for mechanical support by transmitting onto it with as much force, choosing with their index fingers. Results: There was significant decrease in LT, rather than that of NT (p<0.01), and in HT, rather than that of LT (p<0.01), as the results of the distance and velocity of center of pressure (COP) in mediolateral direction at quiet standing position. In anteroposterior direction, the distance and velocity of COP in LT and HT showed significant decrease, when compared to that of the data of NT (p<0.01). There was no significant difference between the 3 conditions (NT, LT, and HT), with respect to the distance and velocity of COP in mediolateral direction, during dynamic balance (squat flexion stage, squat extension stage) (p>0.05). In anteroposterior direction, the results of the distance and velocity of COP in HT showed significant decrease when compared to that of the data of NT (p<0.05). Conclusion: Light touch, during the task, decreased the postural sway at static balance. The results suggest that haptic touch should be applied, appropriately, because it varies the effects according to different conditions.

Current Calculation in Three-Dimensional Finite Element Model (3차원 유한요소 모델에서의 전류계산)

  • Kim, Deok-Won
    • Proceedings of the KIEE Conference
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    • 1987.07b
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    • pp.1288-1291
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    • 1987
  • An finite element code has been developed to calculate current flowing through an 8-node trilinear cubic element from the calculated potentials on the eight node. This code was implemented to the three-dimensional thoracic model for impedance cardiography to find the total currents in the z-direction flowing through the layers which are parallel to x-y plane. The accuracy of the total current was estimated from its variation among the layers. It was found that the accuracy of the total currents in the layers was less than 0.6%.

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혈액정화장치의 현황과 문제점

  • 박한철
    • Journal of Biomedical Engineering Research
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    • v.10 no.2
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    • pp.102-105
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    • 1989
  • In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research.

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Development of a Multipurpose Cure-appliance Using Microwave (마이크로파를 이용한 다목적 치료기의 개발)

  • 박병욱;정병선
    • Journal of Biomedical Engineering Research
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    • v.10 no.2
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    • pp.179-184
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    • 1989
  • There are microwave hyperthermia, microwave surgical knife, and microwave tissue coagulator etc. as the cure-appliance using microwave. The object of this paper is to develope the multipurpose cure-appliance which has the functions that can be used intestinal tumor as well as the existing superficial tumor. And this also have the function of surgical knife and tissue coagulator with endoscope. And then ascertain its functions through the experiments, and to suggest the direction for reserch hereafter.

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