• Journal of the Korean Society of Radiology
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• v.6 no.4
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• pp.281-290
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• 2012

The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.192-197
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• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.107-122
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• 2003

Objectives: The objective of this study is to investigate the use rate and some aspect of complementary therapies used by patients with chronic illness(hypertension, diabetic mellitus and chronic arthritis). Methods: 600 patients visiting the health center for one month(Jan. 2001) were interviewed on their complementary therapies used by the subjects for the previous year. Results: About fourteen-eight percent of the respondents used therapies; 35% of patients with hypertension, 44.6% of patients with diabetic mellitus and 62.9% of patients with chronic arthritis, which shows the highest rate among patients with three chronic disease. The use rate of complementary therapies indicates few meaningful differences according to the general characteristics of the interviewees. Hypertension patients used herb medication(31.0%) acupuncture(29.6%) and most of all the other therapies. Diabetic patients used dietary therapy(57.5%) and herb medication(35.1%). Chronic arthritis patients used acupuncture(85%) and herb medication(34.7%). 36.8% of all the patients who used complementary therapies tried more than two therapies. 18.3% of hypertension patients, 24.1% of diabetic patients and 55.9% of chronic arthritis patients used more than two therapies. Acupuncture(47%) was used most frequently, followed by herb medications(26.3%), health assistance utensils(21.8%). oriental therapy(21.8%), physical therapy(9.5%), health assistance food(8.4%), herb(7.7%), Korea hand acupuncture(3.2%), abdomen respiration(1.1%), and pore therapy(0.7%) Oriental clinic was visited most frequently(42.8%), which was used to cure diseases(61.8%), and to relieve symptoms(26.0%). (p<0.001) The cost spent on complementary therapies last year was 90,000 won(40.3%) and there are some cases of more than 500,000 won(31.2%). Most of the patients(56.1%) were satisfied with the complementary therapies, with 6% of them having side effects. 74% of the patients used complementary therapies answered that they would continue them and 56.1% of them also answered that they would continue them and 56.1% of them also answered that they would advise other patients to do them. Advantages(compared with those of orthodox medical treatment) are psychological comfort(28.1%), body protection(26.0%), effectiveness(20.0%). 34% of the patients using complementary therapies wanted to have informational orientation on complementary therapies. These findings reveal that a considerable number of patients with chronic illness(47.5%) tried a variety of complementary therapies. Though 6% of the patients using therapies had side effects, most of the subjects seemed satisfied with them and they are supposed to continue them. Conclusions: In conclusion, health center personnels and medical doctors should pay more attention to the complementary therapies used by patients with chronic illness. They also have to try their best to advise more scientific and informative complementary programs with less side effects and more help to improve their conditions.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.65-83
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• 2000

To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.157-166
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• 2000

Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

• Journal of Korean Society of Forest Science
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• v.15 no.1
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• pp.1-38
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• 1972

1. Objective of the Study The objective of the study was to make fundamental suggestions for drawing a forest insurance system applicable in Korea by investigating forest insurance systems undertaken in foreign countries, analyzing the forest hazards occurred in entire forests of Korea in the past, and hearing the opinions of people engaged in forestry. 2. Methods of the Study First, reference studies on insurance at large as well as on forest insurance were intensively made to draw the characteristics of forest insurance practiced in main forestry countries, Second, the investigations of forest hazards in Korea for the past ten years were made with the help of the Office of Forestry. Third, the questionnaires concerning forest insurance were prepared and delivered at random to 533 personnel who are working at different administrative offices of forestry, forest stations, forest cooperatives, colleges and universities, research institutes, and fire insurance companies. Fourth, fifty three representative forest owners in the area of three forest types (coniferous, hardwood, and mixed forest), a representative region in Kyonggi Province out of fourteen collective forest development programs in Korea, were directly interviewed with the writer. 3. Results of the Study The rate of response to the questionnaire was 74.40% as shown in the table 3, and the results of the questionaire were as follows: (% in the parenthes shows the rates of response; shortages in amount to 100% were due to the facts of excluding the rates of response of minor respondents). 1) Necessity of forest insurance The respondents expressed their opinions that forest insurance must be undertaken to assure forest financing (5.65%); for receiving the reimbursement of replanting costs in case of damages done (35.87%); and to protect silvicultural investments (46.74%). 2) Law of forest insurance Few respondents showed their views in favor of applying the general insurance regulations to forest insurance practice (9.35%), but the majority of respondents were in favor of passing a special forest insurance law in the light of forest characteristics (88.26%). 3) Sorts of institutes to undertake forest insurance A few respondents believed that insurance companies at large could take care of forest insurance (17.42%); forest owner's mutual associations would manage the forest insurance more effectively (23.53%); but the more than half of the respondents were in favor of establishing public or national forest insurance institutes (56.18%). 4) Kinds of risks to be undertaken in forest insurance It would be desirable that the risks to be undertaken in forest insurance be limited: To forest fire hazards only (23.38%); to forest fire hazards plus damages made by weather (14.32%); to forest fire hazards, weather damages, and insect damages (60.68%). 5) Objectives to be insured It was responded that the objectives to be included in forest insurance should be limited: (1) To artificial coniferous forest only (13.47%); (2) to both coniferous and broad-leaved artificial forests (23.74%); (3) but the more than half of the respondents showed their desire that all the forests regardless of species and the methods of establishment should be insured (61.64%). 6) Range of risks in age of trees to be included in forest insurance The opinions of the respondents showed that it might be enough to insure the trees less than ten years of age (15.23%); but it would be more desirous of taking up forest trees under twenty years of age (32.95%); nevertheless, a large number of respondents were in favor of underwriting all the forest trees less than fourty years of age (46.37%). 7) Term of a forest insurance contract Quite a few respondents favored a contract made on one year basis (31.74%), but the more than half of the respondents favored the contract made on five year bases (58.68%). 8) Limitation in a forest insurance contract The respondents indicated that it would be desirable in a forest insurance contract to exclude forests less than five hectars (20.78%), but more than half of the respondents expressed their opinions that forests above a minimum volume or number of trees per unit area should be included in a forest insurance contract regardless of the area of forest lands (63.77%). 9) Methods of contract Some responded that it would be good to let the forest owners choose their forests in making a forest insurance contract (32.13%); others inclined to think that it would be desirable to include all the forests that owners hold whenerver they decide to make a forest insurance contract (33.48%); the rest responded in favor of forcing the owners to buy insurance policy if they own the forests that were established with subsidy or own highly vauable growing stock (31.92%) 10) Rate of premium The responses were divided into three categories: (1) The rate of primium is to be decided according to the regional degree of risks(27.72%); (2) to be decided by taking consideration both regional degree of risks and insurable values(31.59%); (3) and to be decided according to the rate of risks for the entire country and the insurable values (39.55%). 11) Payment of Premium Although a few respondents wished to make a payment of premium at once for a short term forest insurance contract, and an annual payment for a long term contract (13.80%); the majority of the respondents wished to pay the premium annually regardless of the term of contract, by employing a high rate of premium on a short term contract, but a low rate on a long term contract (83.71%). 12) Institutes in charge of forest insurance business A few respondents showed their desire that forest insurance be taken care of at the government forest administrative offices (18.75%); others at insurance companies (35.76%); but the rest, the largest number of the respondents, favored forest associations in the county. They also wanted to pay a certain rate of premium to the forest associations that issue the insurance (44.22%). 13) Limitation on indemnity for damages done In limitation on indemnity for damages done, the respondents showed a quite different views. Some desired compesation to cover replanting costs when young stands suffered damages and to be paid at the rate of eighty percent to the losses received when matured timber stands suffered damages(29.70%); others desired to receive compensation of the actual total loss valued at present market prices (31.07%); but the rest responded in favor of compensation at the present value figured out by applying a certain rate of prolongation factors to the establishment costs(36.99%). 14) Raising of funds for forest insurance A few respondents hoped to raise the fund for forest insurance by setting aside certain amount of money from the indemnity paid (15.65%); others wished to raise the fund by levying new forest land taxes(33.79%); but the rest expressed their hope to raise the fund by reserving certain amount of money from the surplus money that was saved due to the non-risks (44.81%). 15) Causes of fires The main causes of forest fires 6gured out by the respondents experience turned out to be (1) an accidental fire, (2) cigarettes, (3) shifting cultivation. The reponses were coincided with the forest fire analysis made by the Office of Forestry. 16) Fire prevention The respondents suggested that the most important and practical three kinds of forest fire prevention measures would be (1) providing a fire-break, (2) keeping passers-by out during the drought seasons, (3) enlightenment through mass communication systems. 4. Suggestions The writer wishes to present some suggestions that seemed helpful in drawing up a forest insurance system by reviewing the findings in the questionaire analysis and the results of investigations on forest insurance undertaken in foreign countries. 1) A forest insurance system designed to compensate the loss figured out on the basis of replanting cost when young forest stands suffered damages, and to strengthen credit rating by relieving of risks of damages, must be put in practice as soon as possible with the enactment of a specifically drawn forest insurance law. And the committee of forest insurance should be organized to make a full study of forest insurance system. 2) Two kinds of forest insurance organizations furnishing forest insurance, publicly-owned insurance organizations and privately-owned, are desirable in order to handle forest risks properly. The privately-owned forest insurance organizations should take up forest fire insurance only, and the publicly-owned ought to write insurance for forest fires and insect damages. 3) The privately-owned organizations furnishing forest insurance are desired to take up all the forest stands older than twenty years; whereas, the publicly-owned should sell forest insurance on artificially planted stands younger than twenty years with emphasis on compensating replanting costs of forest stands when they suffer damages. 4) Small forest stands, less than one hectare holding volume or stocked at smaller than standard per unit area are not to be included in a forest insurance writing, and the minimum term of insuring should not be longer than one year in the privately-owned forest insurance organizations although insuring period could be extended more than one year; whereas, consecutive five year term of insurance periods should be set as a mimimum period of insuring forest in the publicly-owned forest insurance organizations. 5) The forest owners should be free in selecting their forests in insuring; whereas, forest owners of the stands that were established with subsidy should be required to insure their forests at publicly-owned forest insurance organizations. 6) Annual insurance premiums for both publicly-owned and privately-owned forest insurance organizations ought to be figured out in proportion to the amount of insurance in accordance with the degree of risks which are grouped into three categories on the basis of the rate of risks throughout the country. 7) Annual premium should be paid at the beginning of forest insurance contract, but reduction must be made if the insuring periods extend longer than a minimum period of forest insurance set by the law. 8) The compensation for damages, the reimbursement, should be figured out on the basis of the ratio between the amount of insurance and insurable value. In the publicly-owned forest insurance system, the standard amount of insurance should be set on the basis of establishment costs in order to prevent over-compensation. 9) Forest insurance business is to be taken care of at the window of insurance com pnies when forest owners buy the privately-owned forest insurance, but the business of writing the publicly-owned forest insurance should be done through the forest cooperatives and certain portions of the premium be reimbursed to the forest cooperatives. 10) Forest insurance funds ought to be reserved by levying a property tax on forest lands. 11) In order to prevent forest damages, the forest owners should be required to report forest hazards immediately to the forest insurance organizations and the latter should bear the responsibility of taking preventive measures.