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The medical 3-dimensional image exchange via health level 7 fast healthcare interoperability resource (HL7 FHIR) (Health level 7 fast healthcare interoperability resource (HL7 FHIR)를 통한 3차원 의료 영상의 교환)

  • Lee, Jung Hwan;Choi, Byung Kwan;Han, In Ho
    • Journal of Digital Convergence
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    • v.18 no.6
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    • pp.373-378
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    • 2020
  • For improving interoperability of medical information, health level 7 has initiated the development of a next-generation framework for the exchange of medical information called the Fast health interoperability resources (FHIR). However, there was no attempt to exchange the medical three-dimensional (3D) image with clinical data via FHIR. Thus, we designed a new method. The 3D image to be made from computed tomography was converted to the javascript object notation (JSON) file format, and clinical data was added. We made a test FHIR server, and the client used the postman. The JSON file was attached to the body, and was then transmitted. The transmitted 3D image could be seen through a web browser, and attached clinical data was identified in the source code. This is the first attempt to exchange the medical 3D image. Additional researches will be needed to develop applications or FHIR resources that apply this method.

Introduction of risk analysis for movement of aquatic animals in Korea (수산동물의 이동에 대한 위험분석의 도입)

  • Seo, Jang-Woo;Park, Myoung-Ae;Choi, Dong-Lim;Kim, Jin-Woo;Cho, Mi-Young;Park, Kyung-Hyun;Jeong, Hyun-Do;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.23 no.1
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    • pp.99-106
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    • 2010
  • Aquatic animal diseases control act which is to assure the prevention of outbreak and spread of aquatic animal diseases in Korea has come into effect since 22 December 2008. In order to prevent outbreak and spread of aquatic animal diseases, risk analysis is newly introduced. The introduction of risk analysis for movement of aquatic animals related to implementation of recommendation of the World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures and should be conducted in accordance with guidelines of OIE Aquatic Animal Health Code. This report involves gathering and analysing the information of international regulation and situations of risk analysis framework in Korea for movement of aquatic animals.

Case analysis of medical dispute about plastic surgery (성형수술과 관련된 의료분쟁 사례 분석)

  • Choi, Min;Sun, Hook
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.262-268
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    • 2009
  • Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.

Analysis of Direct Service Costs about Diabetic Foot Patients (당뇨병성 족부질환자의 직접의료비용 분석)

  • Song, Chong-Rye;Lee, Jin-Woo;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.165-169
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    • 2011
  • Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

On the CIC from the view of Anti Sexual Violence Crime (반(反)성폭력 관점에서 본 친고죄)

  • Park, Sun-Hee;Chae, Jong-Min
    • Journal of forensic and investigative science
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    • v.1 no.1
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    • pp.54-71
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    • 2006
  • The definition of Crime Indictable Upon Complaint (CIC) is crimes which can be prosecuted only with complaints from the victim or his/her direct parents. Sex crimes are the representative examples, rapes and indecent assaults. According to the research referenced in this paper, 74% of sex crimes which had been penalized based on Republic of Korea (ROK) Criminal Code amounts rape and indecent assault are CIC. However, only 20% of perpetrators were confined, and the rest received non-confinement or non-prosecution determination. The review of criminal history checks reveals that 67% of the perpetrators had criminal histories and 39% of them had more than three documented offenses. The CIC was established in order to protect the victim's rights and dignity, respecting the victim's opinion regarding the incident. All kinds of sex crimes then should have been the CIC, but those crimes such as Injury Resulting from Rape, Special Rape, Rape by Special Modus Operandi, Sexual Assault among Relatives and Domestic Violence which have to guarantee the opinion of the victims are prescribed as non-CIC. We therefore conclude that the CIC should be abolished. The abolition of CIC will play an important role in crime prevention because severe penalties for sex crimes will be imposed on the perpetrators. In addition, it will help the sex crime victims retrieve their dignity by spreading recognition widely through the community that sexual assault is not only a social assault but an infringement against human rights.

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Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

The Variation of HbA1c Examination Performance Rates among Diabetic Patients Using Ambulatory Care in South Korea (우리나라 외래서비스 이용 당뇨환자의 특성에 따른 당화혈색소(HbA1c)검사 시행률 변이 분석)

  • Hong, Jae-Seok;Kang, Hee-Chung;Kim, Jai-Yong
    • Health Policy and Management
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    • v.19 no.1
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    • pp.49-61
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    • 2009
  • Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

Modeling Studies of an Exotype Alginate Lyase Atu3025 from Agrobacterium Tumefaciens Strain C58, a Member of Polysaccharide Lyase Family 15

  • Kothandan, Gugan;Cho, Seung Joo
    • Journal of Integrative Natural Science
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    • v.3 no.2
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    • pp.72-77
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    • 2010
  • Alginate lyases, also known as alginases or alginate depolymerases, catalyze the degradation of alginate by a ${\beta}$-elimination mechanism that has yet to be fully elucidated. Alginate is a copolymer of ${\alpha}$-L-guluronate (G) and its C5 epimer ${\beta}$-D-mannuronate (M), arranged as homopolymeric G blocks, M blocks, alternating GM or random heteropolymeric G/M stretches. Almost all alginate lyases depolymerize alginate in an endolytical fashion via a ${\beta}$-elimination reaction. The alginate lyase Atu3025 from Agrobacterium tumefaciens strain C58, consisting of 776 amino-acid residues, is a novel exotype alginate lyase classified into polysaccharide lyase family 15. Till now there is no crystal structure available for this class of proteins. Since there is no template with high sequence identity, three-dimensional coordinates for exotype alginate lyase (PL 15 family) were determined using modeling methods (Comparitive modeling and Fold recognition). The structures were modeled using the X-ray coordinates from Heparinase protein family (PDB code: 3E7J). This enzyme (Atu3025) displays enzymatic activity for both poly-M and poly-G alginate. Since poly-M is widespread; docking of a tri-mannuronate against the modeled structure was performed. We identified some of those residues which are crucial for lyase activity. The results from this study should guide future mutagenesis studies and also provides a starting point for further proceedings.

Developing Asbestos Job Exposure Matrix Using Occupation and Industry Specific Exposure Data (1984-2008) in Republic of Korea

  • Choi, Sangjun;Kang, Dongmug;Park, Donguk;Lee, Hyunhee;Choi, Bongkyoo
    • Safety and Health at Work
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    • v.8 no.1
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    • pp.105-115
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    • 2017
  • Background: The goal of this study is to develop a general population job-exposure matrix (GPJEM) on asbestos to estimate occupational asbestos exposure levels in the Republic of Korea. Methods: Three Korean domestic quantitative exposure datasets collected from 1984 to 2008 were used to build the GPJEM. Exposure groups in collected data were reclassified based on the current Korean Standard Industrial Classification ($9^{th}$ edition) and the Korean Standard Classification of Occupations code ($6^{th}$ edition) that is in accordance to international standards. All of the exposure levels were expressed by weighted arithmetic mean (WAM) and minimum and maximum concentrations. Results: Based on the established GPJEM, the 112 exposure groups could be reclassified into 86 industries and 74 occupations. In the 1980s, the highest exposure levels were estimated in "knitting and weaving machine operators" with a WAM concentration of 7.48 fibers/mL (f/mL); in the 1990s, "plastic products production machine operators" with 5.12 f/mL, and in the 2000s "detergents production machine operators" handling talc containing asbestos with 2.45 f/mL. Of the 112 exposure groups, 44 groups had higher WAM concentrations than the Korean occupational exposure limit of 0.1 f/mL. Conclusion: The newly constructed GPJEM which is generated from actual domestic quantitative exposure data could be useful in evaluating historical exposure levels to asbestos and could contribute to improved prediction of asbestos-related diseases among Koreans.

Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center (민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로)

  • Lim, Jin-Hwa;Choi, Kui-Son;Kim, Sung-Gyeong;Park, Eun-Cheol;Park, Jae-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.329-335
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    • 2007
  • Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.