1.Comparison of the Perception on Health Information Privacy Protection for Electronic Health Record among Patients, Healthcare Providers and Administration Groups.
Inyoung CHOI ; Jiyoung LEE ; Soon CHOY ; Sukil KIM
Journal of Korean Society of Medical Informatics 2007;13(3):197-205
OBJECTIVE: As the accelerated development and use of Electronic Health Record have grown exponentially, the possible disclosure of patient healthcare information is increased. The purpose of this study is to examine the perception gap on disclosure of EHR information among the patient/guardian group, healthcare provider group, and administration group. METHODS: A questionnaire survey from a hospital located in Incheon City of Korea was conducted and over 200 responses were collected. Outcome measures include healthcare information protection, disclosure of unidentifiable information, possible losses from the disclosure of healthcare information, and the ownership of healthcare information. RESULTS: Regarding healthcare information protection, three groups have a general consensus over some issues. In contrast, the healthcare providers and the administration group have a higher consideration regarding possible losses resulting from the disclosure of healthcare information than the patient group. In addition, the healthcare provider group considered the ownership of healthcare information to belong to the hospital in contrast with the patients' view that the ownership and disclosure rights belong to the patient. CONCLUSION: These findings indicate that the high level of interest and concern that our results revealed, suggests that more attention should be directed toward designing and developing policy, organization and legislative systems.
Computer Security
;
Consensus
;
Delivery of Health Care*
;
Disclosure
;
Electronic Health Records*
;
Health Personnel*
;
Human Rights
;
Humans
;
Incheon
;
Korea
;
Outcome Assessment (Health Care)
;
Ownership
;
Privacy*
;
Surveys and Questionnaires
2.Different Perceptions of Clinical Nutrition Services between Doctors and Dietitians in the Busan-Gyeongnam Area.
Journal of the Korean Dietetic Association 2013;19(1):69-81
The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.
Counseling
;
Fees and Charges
;
Food Services
;
Humans
;
Licensure
;
Medical Staff
;
Surveys and Questionnaires
3.Therapeutic New Era for Atopic Dermatitis:Part 2. Small Molecules
Jiyoung AHN ; Yusung CHOI ; Eric Lawrence SIMPSON
Annals of Dermatology 2021;33(2):101-107
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. Currently, we are experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. In contrast to biologics, small molecules are similar to conventional pharmacologic chemical agents used as drugs and are generally prepared by chemical synthesis. Unlike biologics, these drugs often are taken orally or formulated for topical use. The purpose of this review is to summarize the efficacy and safety of the current topical and systemic new therapies in AD by reviewing recently published papers on therapies currently in phase 2 or 3 clinical trials. In this review, it is important to note the characteristics of the study population, the primary endpoints, and whether or not there was concomitant topical therapy allowed. These study design elements may significantly alter the results of studies and should be taken into account. Targeted therapy help push AD treatment into a new era of personalized medicine.
4.Therapeutic New Era for Atopic Dermatitis: Part 1.Biologics
Jiyoung AHN ; Yusung CHOI ; Eric Lawrence SIMPSON
Annals of Dermatology 2021;33(1):1-10
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. We are currently experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. Recently, advances in translational research have challenged the traditional AD pathogenesis paradigm of AD being solely a Th2-dominant disease. Other immune pathways seem to play a role in the complex AD pathophysiology, although the clinical relevance of these additional immune pathway abnormalities is unclear. Type 1, type 22, and type 17 pathway activation (with related cytokines/chemokines) have been demonstrated in the skin and blood of AD patients. Type 2 (interleukin [IL]-4, IL-13), IL-31, and type 22 (IL-22) pathway cytokines are increased in AD acute lesions. IL-22 induces both an epidermal hyperplasia at the onset of acute AD and a marked increase in the terminal differentiation S100 genes.This understanding of pathogenesis corresponds to a historic increase in therapeutic development in AD. The extreme clinical heterogeneity and the chronic progression of AD establish the need for newer, safer, and more effective treatments, control the disease, and improve the quality of life of affected patients.
5.Controversial issues in the legal restriction for prenatal genetic testing in Korea.
Jiyoung CHOI ; Seon Yong JEONG ; Hyon J KIM
Journal of Genetic Medicine 2007;4(2):186-189
More than 6,000 rare disorders including genetic diseases have been reported. Of them, 1,500 diseases (1,211 for clinical diagnosis and 289 for research only) are technically possible for genetic testing. In Korea, since 2005, only 63 genetic diseases is permitted for prenatal genetic testing by the "Bioethics and Biosafety Law". The article 25 in the law prescribes 63 genetic diseases without clear indication for its selection and inclusion criteria. In EU, USA, and other foreign countries, however, there is no provision in the statute on prenatal genetic testing; it is not restricted by a law. Recently, a woman (Mrs. L, 38y) who is a carrier for Menkes disease made an appeal to a government for an amendment of the "Bioethics and Biosafety Law" prohibiting the prenatal diagnosis of her pregnancy at risk for Menkes disease. Menkes disease (MNK) is an X-linked recessive disorder characterized by neurodegeneration, connective tissue defects and hair abnormalities, and no effective treatment is available yet. The prevalence rate of MNK is one in about 250,000 live births. Menkes syndrome patients fail to absorb copper from the gastrointestinal tract in quantities adequate for meeting nutritional needs. These needs seem particularly acute during the initial 12 month of life, when the velocity of brain growth and motor neurodevelopment. Most of pts. die around 3yrs. of age. Mrs. L had a boy with Menkes disease who died at 2y.o. in 2001. Subsequent pregnancy in 2003, she was able to have prenatal genetic testing for mutation of the Menkes (ATP7A) gene and delivered a healthy baby boy. Now, She is pregnant again and wants to have prenatal diagnosis. however, this time, she was not allowed to have any more because Menkes disease is not included in 63 genetic diseases permitted by the law for prenatal genetic testing, in spite of the fact that she is a Menkes disease carrier and her pregnancy is at risk to have an affected baby. This case shows the practical problem of the legal restriction for prenatal genetic testing in Korea. In this study, we report a arguable case and discuss the controversial issues in the legal restriction for prenatal genetic testing in Korea.
Brain
;
Connective Tissue
;
Copper
;
Diagnosis
;
Female
;
Gastrointestinal Tract
;
Genetic Testing*
;
Hair
;
Humans
;
Jurisprudence
;
Korea*
;
Live Birth
;
Male
;
Menkes Kinky Hair Syndrome
;
Pregnancy
;
Prenatal Diagnosis
;
Prevalence
6.National survey for genetic counseling and demands for professional genetic counselor.
Yoon Sok CHUNG ; Sook Ryung KIM ; Jiyoung CHOI ; Hyon J KIM
Journal of Genetic Medicine 2007;4(2):167-178
PURPOSE: The necessity of professional non-MD genetic counselor has been recently emphasized in a medical field. By conducting a national survey on the demands for generic counseling and professional non-MD generic counselor, we can make a long-term master plan to execute the educational program for professional genetic counselors and indeed promote genetic counseling in Korean health care service in a systemic manner. METHODS: The survey has been conducted from September 3rd to October 4th of 2007 in a way of e-mail, telephone interview, fax, and direct contacts. It's targets were senior researchers and professors in medical and non-medical institutions, policy makers, research institutions or foundations. The survey questions consist of 16 questionnaires. RESULTS: As a result of survey, 102 of 650 people responded. 80% of respondents indicated that genetic counseling is needed as a health care service and 34% among them considered it as "the most needed". In addition, 77% of the respondents showed that, it is necessary to have a professional non-MD genetic counselor with a master degree or higher in the field of medical genetics and among them 29% thought it as "the most necessary". A 77% of respondents considered that the cost of genetic counseling should be covered by health insurance and among them, 29% answered "strongly agreed". A 56% of respondents chose the answer of "They have a plan to hire the professional non-MD genetic counselor" in their institution, and among them 71% selected "within 5 years" in terms of when to hire. Also, they tend to expect the role of the professional non-MD genetic counselor to be not only "genetic counselor" (60%), but also "researcher" (42%), "educator" (18%) and "clinical laboratory coordinator" (19%). CONCLUSION: The 102 of 650 people responded to the survey. Based upon the nationwide survey over the needs on genetic counseling in health care service and demands on the professional non-MD genetic counselor, systematic educational program for the genetic counseling, with reimbursement coverage for counseling service by health insurance should be emphasized in development of a master plan.
Administrative Personnel
;
Counseling*
;
Surveys and Questionnaires
;
Delivery of Health Care
;
Electronic Mail
;
Foundations
;
Genetic Counseling*
;
Genetics, Medical
;
Humans
;
Insurance, Health
;
Interviews as Topic
7.Diagnosis of Neuropathies for CMT1A and HNPP Using the Microsatellite Multiplex PCR System.
Byung Ok CHOI ; Sun Wha PARK ; Jiyoung YUN ; Ki Wha CHUNG
Journal of the Korean Neurological Association 2005;23(6):796-805
BACKGROUND: Tandem duplication of chromosome 17p11.2-p12 including peripheral myelin protein 22 (PMP22) gene is the most frequent cause of Charcot-Marie-Tooth 1A (CMT1A). Patients carrying one extra copy of PMP22 develop CMT1A, whereas the deletion of the 17p11.2-p12 region causes hereditary neuropathy with the liability to pressure palsies (HNPP). In the present study, we established the genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the 17p11.2-p12 regions by the hexaplex PCR for the genetic diagnosis of CMT1A duplication and HNPP deletion. METHODS: We established polymorphic behavior and genotyping methods of 6 microsatellite markers (D17S921, D17S9B, D17S9A, D17S4A, D17S918 and D17S122) within the duplication region. The 6 markers were amplified by hexaplex PCR reaction and analyzed by an automatic sequencing analyzer and genotyper program. RESULTS: The genotype distributions of all markers were not significantly deviated from the Hardy-Weinberg equilibrium (P>or=0.05). When comparing the control group and CMT1A, HNPP patients group by the distribution of allele, there is no significant difference in the 5 locus except in the 1 locus (D17S921) among HNPP patients. The specificity was more than 99.9%. The sensitivity of each CMT1 and HNPP was 56.3% (40/71 pedigrees) and 72.1% (31/43 HNPP pedigrees), respectively. CONCLUSIONS: The error rate for the system may be less than 0.001. According to this study, it is possible to have rapid and exact genetic diagnosis of both CMT1A and HNPP, which may be helpful for the development of personalized therapy according to genetic defects.
Alleles
;
Charcot-Marie-Tooth Disease
;
Diagnosis*
;
Genotype
;
Humans
;
Microsatellite Repeats*
;
Multiplex Polymerase Chain Reaction*
;
Myelin Sheath
;
Paralysis
;
Polymerase Chain Reaction
;
Sensitivity and Specificity
8.Comparison of Spiritual Needs between Patients with Progressive Terminal Kidney Disease and Their Family Caregivers
Ye-Jean KIM ; Oknan CHOI ; Biro KIM ; Jiyoung CHUN ; Kyung-Ah KANG
Korean Journal of Hospice and Palliative Care 2020;23(1):27-38
Purpose:
The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers.
Methods:
An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffé test, and multiple regression with dummy variables.
Results:
The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked subdimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking “why?”, receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking “why?”. The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group.
Conclusion
The results of this study may serve as evidence that spiritual care for non-cancer patients’ family caregivers should be considered as an important part of hospice and palliative care.
9.The Effects of Silica Nanoparticles in Macrophage Cells.
Seungjae KIM ; Jiyoung JANG ; Hyojin KIM ; Hoon CHOI ; Kangtaek LEE ; In Hong CHOI
Immune Network 2012;12(6):296-300
Silica nanoparticles, which are applicable in many industrial fields, have been reported to induce cellular changes such as cytotoxicity in various cells and fibrosis in lungs. Because the immune system is the primary targeting organ reacting to internalized exogenous nanoparticles, we tried to figure out the immunostimulatory effect of silica nanoparticles in macrophages using differently sized silica nanoparticles. Using U937 cells we assessed cytotoxicity by CCK-8 assay, ROS generation by CM-H2DCFDA, intracellular Ca++ levels by staining with Fluo4-AM and IL-8 production by ELISA. At non-toxic concentration, the intracellular Ca++ level has increased immediately after exposure to 15 nm particles, not to larger particles. ROS generation was detected significantly in response to 15 nm particles. However, all three different sizes of silica nanoparticles induced IL-8 production. 15 nm silica nanoparticles are more stimulatory than larger particles in cytotoxicity, intracellular Ca++ increase and ROS generation. But IL-8 production was induced to same levels with 50 or 100 nm particles. Therefore, IL-8 production induced by silica nanoparticles may be dependent on other mechanisms rather than intracellular Ca++ increase and ROS generation.
Enzyme-Linked Immunosorbent Assay
;
Fibrosis
;
Immune System
;
Interleukin-8
;
Lung
;
Macrophages
;
Nanoparticles
;
Silicon Dioxide
;
Sincalide
;
U937 Cells
10.Effects of Very Low Calorie Diet using Meal Replacements on Psychological Factors and Quality of Life in the Obese Women Aged Twenties.
Jiyoung KIM ; Sangyeon KIM ; Kyunga JUNG ; Yukyung CHANG ; Hyeongsuk CHOI ; Sung CHOI ; Mihyeon PARK ; Seonggil HONG ; Sungjoo HWANG
The Korean Journal of Nutrition 2007;40(7):639-649
This study was performed to investigate the effects of very low calorie diet (VLCD) using meal replacements that contain the wild grass extracts based on Samul-tang ingredients on psychological factors and quality of life in the obese women (BMI > or = 25 kg/m2) for four weeks. Seventy five women (20 < or = age < 26) participated in this experiment. Subjects were randomly classified three groups: 1) General diet group (GD group, n = 27) consumed 3 regular meals within 600 kcal/day 2) Meal replacements group (MR group, n = 27) consumed 1 regular meal and 2 meal replacements within 600 kcal/day 3) Herbal Meal replacements group (HMR group, n = 27) consumed 1 regular meal and 2 meal replacements within 600 kcal/day. Physical factors (weight, BMI, fat(%)) of the HMR group significantly decreased more than those of GD and MR groups. Moreover, binge eating habit and environmental factors (surrounding support, emotional reaction, expression of opinion) of the HMR group significantly decreased more than those of GD and MR groups. Psychological factor and quality of life were no significant differences among three groups during the experimental period, because both were significantly decreased in all groups after 4 weeks. Therefore, very low calorie diet using meal replacements that contain the wild grass extracts based on Samul-tang ingredients for 4 weeks was effective on improvement of psychological factor and quality of life as well as weight reduction in the obese premenopausal women.
Bulimia
;
Caloric Restriction*
;
Diet
;
Female
;
Humans
;
Meals*
;
Poaceae
;
Psychology*
;
Quality of Life*
;
Weight Loss