• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.37-80
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• 2022

By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

• Journal of Korean Physical Therapy Science
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• v.3 no.2
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• pp.1021-1036
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• 1996

The purpose of this study are ( i ) to examine operating situation of physical therapy department and job satisfaction of physical therapists in health centers, (ii) to analyze utilization patterns and patient satisfaction of physical therapy services among health center visitors, and finally, (iii) to suggest policy implications in facilitating improvement on physical therapy services of health centers. The materials are collected from 105 physical therapists among nationwide health centers and 203 patients of 5 health centers in Pusan, Korea. The survey is conducted from February 13 to March 30, 1996 with a structured self - administered questionnaire. Major results of the study are as follows. First, the result of regression analysis between job satisfaction and affecting factors identify following variables as the significant determinants; self-development(+), job itself(+), and co-worker support (+). Second, the current operating situation of physical therapy department shows such problem as; i )shortage and unstable job security of physical therapists, ii )absence of rehabilitation specialist, iii )lack of understanding on physical therapy of co-workers, iv)shortage of physical therapy equipment and facility, v)burdensome task of physical therapists, and vi) inappropriate purchase process of equipment. Third, patient satisfaction for physical therapy services are revealed relatively high. And the result of regression analysis between patient satisfaction and affecting factors identify following variables as the significant determinants; credibility of physical therapist(+), satisfaction for waiting time(+), cleanliness(+). Fourth, the patients appeal about physical therapy services such problem as; i) shortage of physical therapists, physical therapy equipment, and facility, ii) inconvenient administrative procedure for utilization physical therapy services. Fifth and last, recommendations for the improvement of physical therapy services of health centers are as follows; i )recruiting more physical therapists, ii )regular employment of physical therapists instead of daily use employment, iii )re-arrangement of facility for patient's convenience, iv )establishing reasonable purchasing system of equipment for physical therapy, v) reforming administrative procedure for patient focused care.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.4
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• pp.581-586
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• 2018

A common characteristic of many patients whose illness is getting worse is that they miss the treatment red flag. When high subjective symptoms appear or there is no strong pain, this problem arises because it is reluctant to visit the hospital. Gingivitis causes bleeding from the gums in the early and mid-term, and shows mild symptoms of tooth collapse. When treatment is done at this point, it shows a very high effect. However, when you miss the timing of treatment you will have a situation where you can't eat food by causing serious problems in the health of the gums and oral cavity. In this paper, the patient's periodontal image is photographed with a smartphone and transmitted in real time. This is done by the doctor in charge. Then, we propose a design of a patient management system that provides information on the current situation to the patient so as not to miss the timing of treatment.

• Journal of Digital Convergence
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• v.12 no.7
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• pp.279-284
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• 2014

Recently, m-health care is be a problem that the patient's information is easily exposed to third parties in case of emergency situation. This paper propose an attribute-based access control protocol to minimize the exposure to patient privacy using patient information in the emergency environment. Proposed protocol, the patient's sensitive information to a third party do not expose sensitive information to the patient's personal health information, including hospital staff and patients on a random number to generate cryptographic keys to sign hash. In addition, patient information from a third party that is in order to prevent the illegal exploitation of the patient and the hospital staff to maintain synchronization between to prevent the leakage of personal health information.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.213-218
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• 1973

Raynaud attempted to clarify the situation concerning symmetrical and spontaneous gangrene in a thesis published in 1952. The disease was defined as Raynaud`s phenomenon without associated and contributing conditions or disease, and described as two types, such as, `locale syncope and asphyxia` and `gangrene`. Predilection of Raynaud`s disease for female under 40 years of age wi-thout any vascular occlusive disease beginning in the early decades of life and typical color changes in the skin of the extremities incited by coldness are outstanding features in this disease. One typical case of Raynaud`s disease is presented with relating references. Patient was 24 year old female single patient, who noted pain, numbness, and cyanosis of the finger tips of both hands for 6 years previously in the winter season, and recently such symptoms were aggravated including her both feet for two years even in the summer after exposure to cold water. Physical and laboratory examination revealed nothing specific except slightly glistening tight face and hypertrophy of both finger tips with clammy coldness. FamiliaI and past history revealed nothing specific abnormal contributory factors. Biopsy of skin on the dorsum of right foot one year before this admission revealed no evidence of scleroderma. Treatment was aimed to relieve vasospasmodic reaction to coldness and was very successful with bilateral lumbar and thoracic sympathectomy. Patient is free of symptoms relating to the Raynaud’s phenomenon after sympathectomy for 6 months including winter season.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.98-100
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• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.439-455
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• 1998

This is the descriptive investigation study intended to provide basic informations to develop concrete method of nurse arbitration which can improve the quality of nursing care on family by investigating and analyzing the perception and practice on family nursing of clinical nurse. 332 nurses working in 4 university hospitals in Seoul have been the object and the collection of data have been conducted by visiting cooperated by the department of nursing in university hospital from April 4th through April 17th 1998. The measuring instrument of the perception and the practice on family nursing which was written by the researcher was used based on the family nursing arbitration by recently amending Calgary Family Arbitration of the Model of Wright & Leahey. Cronbach's a value of this instrument was .9288 in the perception and .9168 in the practice the collected data have been analyzed by frequency percentage, averaged value. t-test, F-test(ANOVA), Duncan's Multiple Range, Pearson's Correlation Coefficient, and the results are as the follows: 1. The perception on patient's family nursing of clinical nurse showed comparatively high by 3.22 in average(maximum 3.52, minimum 2.82) on the basis of 4 point but the practice showed low by average 2.47(maximum 3.02, minimum 2.11), By providing the patients and their family with "The information about the health problem of the which is the role of giving explanation and information about the disease. the nurse presents the method of their helping patient and in case that the family lack of knowledge about the health problem and crisis of the patient which is the role of education about the method of solving the crisis and change. the nurse educates about the necessity and method of taking care of the crisis and the changes. The third question that the relation of recognizing the difficuly of family and cooperating with them in supporting the patient for mutual function is to be formed showed high in the degree of perception and practice of the necessity. 2. General characteristics of perception about patient's family nursing of the object showed no significant difference except the concerns about the family usually(F=5.472. p<.001) and general characteristics which showed significant difference in the degree of practice were educational background (F=3.177, p<.05), clinical experience (F=2.462, p<.05) and position(F=7.029. p<.001), and attention about patient's family(F=10.603, p<.001), 3. The relation between perception and practice about the nursing on patient's family showed pure correlation but the degree was very low(r=.188, p<.05). The above results showed that the clinical nurses has been high understanding about the necessity of patient's family nursing but the degree of practice has been very low due to the lack of education about the family nursing, having no ways of nurse arbitration for practical duty and lack of political administrative support. Therefore concrete and systematic family situation and arbitration method to be applied clinically are required to be developed and also the education about patient's family nursing and the development of the course for clinical practice are required and political and administrative support for clinical practice about patient's family nursing is required as well.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.73-77
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• 2001

Object : To determine whether to use surgical or medical therapy in treatment of infectious intracranial aneurysms, we reviewed two recent cases of infectious intracranial aneurysms and others known previous reports of aforementioned cases. Hence, we attempted to compare the validity and effectiveness of surgical and medical treatment. Method : Recently, we treated two cases of ruptured infectious intracranial aneurysms. In former case, the aneurysm was located distal to the middle cerebral artery in a patient with mild mitral regurgitation of the heart. In latter case, the aneurysm was multiple with varying hemorrhage. The hemorrhage was located bilaterally and a moderate mitral regurgitation and infective endocarditis were accompanied in this patient. Result : Due to the large size of the intracranial hematoma, stable medical condition, and easy resectability, we treated the former patient surgically. And, because of successive hemorrhage by multiple aneurysmal rupture, and the risk of heart failure, we treated the latter patient medically with serial follow-up angiography. Both patients are at present in good health. Conclusion : Because of the variability in associated factors, such as the patient's health, the number of lesions, location, anatomy of the aneurysms and the causative organism, each patient's care must be individualized and tailored to the patient's particular clinical situation.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.56 no.9
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• pp.1680-1687
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• 2007

A hospital room has multiple patient monitoring devices at the bedside to monitor his or her status. However, vital sign monitors, ventilator and other bedside devices are made by a variety of different manufacturers and often cannot easily interface to the hospital information system. Medical environments incorporate complex and integrated data networks to transfer vast amounts of patient information, such as images, waveforms, and other forms of digital data. Hence, to assure interoperability of images, waveforms and patient data, Health Level Seven (HL7) was developed as an international standard to facilitate the communicating and storing of medical data. In this study, we developed middleware capable of receiving data from mCare 300 vital signs monitoring devices and converting the data to HL7 data format. The HL 7 middleware streamline clinical workflow and support patients. Therefore, clinical expertise are empowered to respond to dynamic healthcare situation as soon as they emerged, and consequently quality of care while helping to reduce the length of a patient's stay in a hospital.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.269-279
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• 2011

Objectives: The purpose of this study was to investigate the clinical application of blood-letting therapy and oriental medicine with arteriosclerosis obliterans. Methods: The patient in this case had been already treated by anticoagulation, percutaneous transluminal angioplasty and thrombolysis. But these methods didn't work on patient and condition had gone bad. Finally the patient's left limb was about to be amputated. Patient did not wall to cut off her lower limb, so she visited us to find a way for treating and preserving her lower limb. A drastic treatment was necessary in this situation. We treated the patient with Korean traditional treatment. Specially excessive blood-letting therapy and oriental medicine helped the patient to decrease the pain, numbness and frigidity. Results: After treatment the chief complaint and accompanying symptoms were subsided and improved. And personal and social performance scale was increased. Conclusions: According to this study, Korean traditional treatment such as blood-letting therapy, and oriental medication is effective for the cure of arteriosclerosis obliterans. During this period, foot necrosis was delayed and amputation is not needed any more.