• Journal of the Korea Society of Computer and Information
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• v.17 no.12
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• pp.241-249
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• 2012

The rapid development of the current information and communication brings big changes and progress in the health service delivery system. And it is becoming the worldwide trend increasingly. As the name of medical information, by more rapid, detail and more quickly to the patients and diagnosis of the disease it provides not only a high level of health care services but also hospitals and related institutions are making increase the efficiency of the work. Among them, the Telemedicine, that system has many advantage which can expect the shorten the waiting time and the uniform high level of medical, etc. without visiting medical institutions. Especially, the most advantage is it can increase the accessibility of information about extensive medical, without regard to the time and place. But this is the reality, which compared speed the development of modern science and technology with lack of operational regulations and mindset. Current in our Medical Law, it regulates the Telemedicine, but it has Institutional, facility, and environmental constraints. Because, there is no detailed legal relationship. And it takes that in terms of a special form called by a non-face-to-face contact with medical practice rather than the scene. Therefore, in this paper will find a way out to activate the Telemedicine by presupposes the development potential is infinite and find the legal issues and improvements.

• 재활복지
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• v.21 no.3
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• pp.107-127
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• 2017

The objective of this study is to suggest measures to support the community-based rehabilitation sports service for health of people with disabilities, which can be applicable to South Korea, by analyzing the rehabilitation sports service support system of Germany and Japan. Through literature review and direct visiting to Japan, the researcher explored such factors as, background of initiating the rehabilitation sports service, concept, range, and subject of theservice, service delivery procedure, and institutions, and finance of the service. The institutional implications are as follows: First, the concept and range of rehabilitation sports are gradually expanding. Initially, the rehabilitation sports started targeting for veterans with disabilities for the purpose of medical rehabilitation in Germany and Japan. As time passes, however, the importance of rehabilitation sports has emphasized, and the subjects have gradually expanded for the purpose of preventing disability or secondary diseases caused by disability. Second, in order to perform rehabilitation sports service, it is essential to have manpower with expertise in medical treatment, welfare, disability, and exercise prescription, likewise Germany and Japan do. Third, Germany and Japan emphasize the assignment of rehabilitation sports instructors in institutions, rather designating specific institutions, which is moving toward the manpower-based rehabilitation sports service, rather place-based service. Fourth, rather having simple medical programs or sports-oriented programs, it would be necessary to have the systematized disease-oriented programs for each type of disability. Lastly, the clients-oriented service delivery process should be established.

• Journal of Arbitration Studies
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• v.30 no.4
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• pp.121-138
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• 2020

The O2O services in the healthcare sector have only been in full swing for about three years, and unlike existing O2O consumer goods, the scale and scope of the dispute are more complicated due to restrictions on medical treatment. In this study, O2O service platform operators and medical institutions' roles and responsibilities were redefined as a countermeasure for resolving disputes in healthcare O2O services and the laws for changing the transaction environment. A change in institutional mechanisms was proposed. This study looked at the types of consumer disputes related to healthcare O2O services as insufficient information problems, problems in the course of medical service implementation, problems with immunity provisions for platform operators, cancellations, and non-compliance with refunds. All the information generated during transactions in the healthcare sector was extensive in scale and included the most sensitive information among personal information, stressing the importance of ensuring security. The area that started in the O2O range before the medical institution visit also proposed a plan to establish a system for the delivery of proven information as a pre-medical person. The scale and growth will grow faster, given that consumers can experience the information they want anytime, anywhere they want. However, the platform broker's role, a link player, will become more important because consumers who use the service will have their first meeting with non-face-to-face product providers. On the other hand, service providers may have side effects of misleading consumers by providing false information or misleading consumers through exaggerated advertisements. The O2O service market is expected to expand beyond distribution and dining out to the entire industry. However, since it is challenging to check accurate statistics on the detailed market, various disputes and consumer protection measures will be required for each detailed market, and comprehensive leading solutions will be essential in the future.

• Korea Journal of Hospital Management
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• v.29 no.3
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• pp.54-69
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• 2024

Purposes: This study aims to analyze the location patterns, concentration, and accessibility of clinics in Seoul with the grids of a geographic information system(GIS) and provide useful indicators for research on hospital and clinic management and policies based on the results. The study especially sets out to identify areas falling behind in the service of the essential medical care departments based on an analysis with 250m×250m grids and contribute to efficient medical business management and public healthcare policies based on the results. Methodology: The study analyzed clinics in Seoul in terms of concentration, distribution and clustering patterns, accessibility, and hot spots by dividing the entire city into 500m×500m cells and generating grids. The accessibility analysis for the essential medical care departments was especially in detail based on grids in a 250m×250m cell size. Findings: The Herfindahl results show that plastic surgery and rehabilitation medicine recorded the highest concentration level. General medicine and dermatology recorded the highest Moran's I value, and internal medicine was the highest in hot spots. Obstetrics and gynecology capable of child delivery showed considerably lower accessibility in the grids corresponding to Gangseo-gu, Yangcheon-gu, and Gwanak-gu. Surgery had low accessibility in the grids corresponding to the northern parts of Gangseo-gu for the total population. Practical Implication: Unlike previous studies whose analyses covered wide areas, the present study examined minute spatial patterns, concentration, and accessibility based on an analysis with 500m×500m or 250m×250m grids. Based on its findings, the study expects a more minute analysis for future research on medical business management and policies.

• Progress in Medical Physics
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• v.26 no.2
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• pp.87-92
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• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.2
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• pp.65-72
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• 2014

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

• BMB Reports
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• v.57 no.1
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• pp.60-65
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• 2024

The CRISPR-Cas9 system has significantly advanced regenerative medicine research by enabling genome editing in stem cells. Due to their desirable properties, mesenchymal stem cells (MSCs) have recently emerged as highly promising therapeutic agents, which properties include differentiation ability and cytokine production. While CRISPR-Cas9 technology is applied to develop MSC-based therapeutics, MSCs exhibit inefficient genome editing, and susceptibility to plasmid DNA. In this study, we compared and optimized plasmid DNA and RNP approaches for efficient genome engineering in MSCs. The RNP-mediated approach enabled genome editing with high indel frequency and low cytotoxicity in MSCs. By utilizing Cas9 RNPs, we successfully generated B2M-knockout MSCs, which reduced T-cell differentiation, and improved MSC survival. Furthermore, this approach enhanced the immunomodulatory effect of IFN-r priming. These findings indicate that the RNP-mediated engineering of MSC genomes can achieve high efficiency, and engineered MSCs offer potential as a promising therapeutic strategy.

• Progress in Medical Physics
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• v.20 no.3
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• pp.174-179
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• 2009

To track moving tumor in real time, CyberKnife system imports a technique of the synchrony respiratory tracking system. The fiducial marker which are detectable in X-ray images were demand in CyberKnife Robotic radiosurgery system. It issued as reference markers to locate and track tumor location during patient alignment and treatment delivery. Fiducial marker implantation is an invasive surgical operation that carries a relatively high risk of pneumothorax. Most recently, it was developed a direct lung tumor registration method that does not require the use of fiducials. The purpose of this study is to measure the accuracy of target applying X-sight lung tracking using the Gafchromic film in dynamic moving thorax phantom. The X-sight Lung Tracking quality assurance motion phantom simulates simple respiratory motion of a lung tumor and provides Gafchromic dosimetry film-based test capability at locations inside the phantom corresponding to a typical lung tumor. The total average error for the X-sight Lung Tracking System with a moving target was $0.85{\pm}0.22$ mm. The results were considered reliable and applicable for lung tumor treatment in CyberKnife radiosurgery system. Clinically, breathing patterns of patients may vary during radiation therapy. Therefore, additional studies with a set real patient data are necessary to evaluate the target accuracy for the X-sight Lung Tracking system.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• The Journal of the Korea institute of electronic communication sciences
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• v.17 no.2
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• pp.387-392
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• 2022

In addition to complying with access standards for facilities that require infection control (operating rooms, delivery rooms, intensive care units, etc.) in accordance with the 2019 Medical Care Act Enforcement Regulations, entry, exit, contact information, etc. for entry and exit, the criteria for entering and exiting special rooms of medical institutions have been revised so that records of facts are kept for one year. However, even now, the inconvenience continues due to the fact that such contents are created by hand or due to errors. For this reason, this study designed and implemented a system that provides automatic opening, closing, and accessing record storage functions for authorized users using IoT devices and UWB technology, and we expected that the convenience of the visitors and systemized access control will be possible.