• Title/Summary/Keyword: 기준선 조정

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Feasibility and Safety of a Technique Intended to Place the Catheter Tip in the Right Atrium without Abutment Against the Cardiac Wall during Implantation of the Totally Implantable Venous Access Port (완전이식형 정맥 접근 포트 삽입 시 카테터 팁을 심벽에 닿지 않고 우심방 내 위치시키는 방법의 타당성과 안전성)

  • Hyejin Park;Tae-Seok Seo;Myung Gyu Song;Woo Jin Yang
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.161-170
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    • 2024
  • Purpose To assess the safety and feasibility of intentionally positioning the catheter tip in the right atrium (RA) without an abutment during implantation of a totally implantable venous access port (TIVAP). Materials and Methods We enrolled 330 patients who had undergone TIVAP implantation between January and December 2016 and postoperative chest CT. The TIVAP was placed using the single-incision technique to access the axillary vein directly from the incision line. To position the catheter tip in the RA without abutment, blood return was checked before cutting. Catheter length and complications were evaluated by retrospectively reviewing medical images and records. Results All patients achieved successful catheter tip positioning without abutment or dysfunction. The median tip position was 15.3 mm distal to the cavoatrial junction (CAJ) on fluoroscopy and 6 mm distal to the CAJ on CT. Catheter tips migrated a median of 10.4 mm cephalically on CT compared to fluoroscopy. Thromboses were detected in the RA and superior vena cava in one patient each. Conclusion Intentional catheter tip positioning in the RA without abutment is a safe and feasible technique with a low incidence of thrombosis and no observed dysfunction.

Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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Study on the Design Ideas and Planning Method of the Gameunsa Temple Architecture in Silla (신라감은사건축의 계획이념과 설계기술 고찰)

  • Lee, Jeongmin
    • Korean Journal of Heritage: History & Science
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    • v.54 no.1
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    • pp.238-259
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    • 2021
  • Gameunsa Temple is a Buddhist temple from the mid-Silla period. Construction began during the reign of King Munmu and was completed during the second year of King Sinmun's reign (682). This study is based on the results of excavations at the Gameunsa Temple site, exploring the findings presented in the literature in the field of history. This study also investigates the characteristics of the construction plan of Gameunsa Temple and its correlation with the political, social, and religious environment of the time. The results of the study are as follows: (1) First, it is confirmed that all of the buildings in the central block of Gameunsa Temple, such as the pagoda and corridor, the central gate, and the auditorium, fit within 216 cheoks by 216 cheoks (Goguryeo unit of measurement, estimated dimensions 353.30 mm), in terms of the base structure. This fact is highly significant considering the intent of the King in the mid-Silla period to advocate Confucian political ideals at the Donghaegu sites (Daewangam, Igyeondae Pavilion, and Gameunsa Temple), as confirmed by the relationship between the 'Manpasikjeok legend' and the Confucianism of the etiquette and the music; the relationship between the name of the 'Igyeondae Pavilion' and the 'I Ching'; and the relationship between the 'Taegeuk stones excavated from the Gameunsa Temple site' and the 'I Ching.' Additionally, it may be presumed that the number in the "Qian 216" on the Xici shang of 'I Ching' was used as a basis for determining the size of the central block in the early stages of the design of Gameunsa Temple. The layout of the halls and pagodas of Gameunsa Temple was planned to be within a 216-cheok-by-216-cheok area, from the edge to the center, i.e., on the central axis of the temple, in the following order: the central gate and auditorium, the north-south position of Geumdang Hall, the south corridor, the east-west buildings of the auditorium and the winged corridor, the east-west corridor, and the central position of the east-west stone pagoda. (2) Second, the coexistence of Confucianism and Buddhism in the architecture of Gameunsa Temple is based on the understanding of the Golden Light Sutra, originating from the aspirations of King Munmu to obtain the immeasurable merits (陰陽調和時不越序 日月星宿不失常度 風雨隨時無諸災横) and the light of the Buddha, which is metaphorically represented by the sun and the moon illuminating the whole world of Silla, a new nation with a Confucian political ideology, for a long time by "circumambulating the Buddha (旋繞)". It is also presumed that Gyeongheung, who was appointed by King Munmu to be the Guksa in his will and appointed as the Gukro after the enthronement of King Sinmun, was deeply involved in the conception and realization of the syncretism of Confucianism and Buddhism.

Optimization and Stabilization of Automated Synthesis Systems for Reduced 68Ga-PSMA-11 Synthesis Time (68Ga-PSMA-11 합성 시간 단축을 위한 자동합성장치의 최적화 및 안정성 연구)

  • Ji hoon KANG;Sang Min SHIN;Young Si PARK;Hea Ji KIM;Hwa Youn JANG
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.2
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    • pp.147-155
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    • 2024
  • Gallium-68-prostate-specific membrane antigen-11 (68Ga-PSMA-11) is a positron emission tomography radiopharmaceutical that labels a Glu-urea-Lys-based ligand with 68Ga, binding specifically to the PSMA. It is used widely for imaging recurrent prostate cancer and metastases. On the other hand, the preparation and quality control testing of 68Ga-PSMA-11 in medical institutions takes over 60 minutes, limiting the daily capacity of 68Ge/68Ga generators. While the generator provides 1,110 MBq (30 mCi) nominally, its activity decreases over time, and the labeling yield declines irregularly. Consequently, additional preparations are needed, increasing radiation exposure for medical technicians, prolonging patient wait times, and necessitating production schedule adjustments. This study aimed to reduce the 68Ga-PSMA-11 preparation time and optimize the automated synthesis system. By shortening the reaction time between 68Ga and the PSMA-11 precursor and adjusting the number of purification steps, a faster and more cost-effective method was tested while maintaining quality. The final synthesis time was reduced from 30 to 20 minutes, meeting the standards for the HEPES content, residual solvent EtOH content, and radiochemical purity. This optimized procedure minimizes radiation exposure for medical technicians, reduces patient wait times, and maintains consistent production schedules, making it suitable for clinical application.

Health Promotion Through Healthy People 2010 ("2010년대 건강한 시민" 정책을 통한 미국의 건강증진 방향)

  • Cho, Jung H.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.17-58
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    • 2004
  • 뉴저지주 보건교육/건강 증진정책을 논하기전에 건강증진과 보건 교육사의 뜻을 먼저 기술하기로 한다. 건강증진이란 일상 사회생활과 행동과학의 응용에서 시작하며 교육의 효율적 작전 및 기술, 질병 역학 조사, 개인 및 가족단위 건강 위해 행위 절감, 사회연관 구축망 조성, 그리고 적게는 이웃, 더 나아가 조직체계 및 지역 사회의 네트웍 실시등을 실시한다. 보건교육 및 건강증진 전문가란 ' 전국 보건교육 인증 위원회(NCHEC) ' 에서 채택된 다음 7개 활동 영역에서 개인적, 그룹, 각주단위, 그리고 범 국가적 조직에서 종사하는자로 한다. 개인 및 지역사회 보건 교육 필요성 분석- 계회, 실행, 효율성 평가, 사업 진행 조정, 자문, 컴뮤니케이션 등의 활동범위를 들 수 있다. 공인 보건 교육사(CHES)란 대학 및 대학원에서 보건 교육학 소정의 필수 과목을 이수하고 학.석사 소지자로서 ' 전국 보건 교육 인증 위원회 ' 에서 그 자격을 인정 받고 공인 자격 시험에 합격한자로 한다. 합격자는 자기 성명뒤에 CHES란 칭호를 부치며 매 5년마다 75단위이상 인정된 전문 직업 보수 교육을 받아야 한다. 보건 교육사 고용 분야는 연방, 주, 지방 정부의 보건 교육사(10-15%) 및 건강 증진 전문가로 종사하며; 이들은 지역 사회 조직화, 프로그람 기획, 공공사업 마켓팅, 메디아, 컴뮤니케이션 자질을 갓추어야 하며; 상해 예방, 학교 보건, 지역 사회 영양 실태 향상, 그 외 모든 건강 증진과 질병 예방에 일익을 담당 하여; 의사, 간호사, 약사, 영양사,환경 위생사드의 전문분야종사자들괴 한팀이 되어 지역 사회 보건 사업에 기여한다. 쥬저지 보건 교육사들은 주법령 8조 '||'&'||' 보건행정 표준 시행령 ' 에 따라 포괄적 보건교육/건강증진 프로그램을 개발하여 총체적으로 조절 관장한다. 특희 ' 미국 학술원 의료 연구원 ' 에서 제정한 ' 10대 필수 공중 보건 사업 ' 에 기준을 두고; 1) 개인 및 지역사회 필수 보건 여건 분석 평가, 2) 보건 교육 이론에 따른 사업 계획 설정, 3) 교육 전략과 보건문제 발굴에 따라 일반 대중 대상 보건 교육 실행 (프로그람 기획, 연수 교육, 미디어 캠페인, 공중보건 향상책 옹호), 4) 사업 진행 과정 정리, 그 결과에 대한 영향력과 결과 평가, 5) 프로그램진행, 인사 및 예산관리 참여, 6) 근무향상을 위한 보수교육 프로그램 개발, 7) 보건 의료 업무 종사자 상호 협조성 향상 훈련, 8) 지역 사회자원 밭굴, 9) 적절한 고객 의뢰 체제 시행, 10) 위기 관리 컴뮤니케이션 체제 개발실시, 11) 일반 대중에게 공중 보건 향상 고취, 12) 각종 협력 지원금 신청서 작성 제출, 13) 문화/인종적으로 적절한 시청각 교재 발굴, 15) 질적 및 양적 보건교육/건겅증진책 연구 실시, 16) 비 보험 가담자, 저 보험자, 빈곤자, 이민자 색출 선도, 17) 관활 구역내 상재하는 각 건강증진 프로그램 밝혀 내서 불필요한 중복 회피등이다. 그 외에도 보건 교육사들은 사회 복지 단체인 미국 암 협회, 미국 심장 협회,미국 폐장 협회 등 각종 사회 복지 비영리단체 와 자선 사업 단체들과 긴밀희 협조하거나 그 단체 임직원으로서 건강 증진 사업에 종사한다. 병원 및 의료기관에선 임직원 보수 교육, 환자의 질병 예방및 건강증진 교육, 그리고 의료 사업장내 건장 증진업무에 종사한다. 건강 유지 의료 기관(HMO)에선 예방주사, 정기검진 촉진등을 통한 입원일수 절감, 응급실 사용도 절감등으로 의료비 감축, 삶의질 향상상에 종사한다. 사업장 보건 교육사는 스트레스 관리, 금연 및 흡연 중단선도, 체중 절감, 종업원 건강증진 생활화참여 유치, 컴뮤니케이션 개발, 마켓팅, 질병 예방등에 그 전문 직업적 노하우를 사업체 건강 증진 프로그램 개발에 접목한다. 뉴저지 2010년대 건강 증진책은 5대 목표 설정하여 현재 시행하고 있다. 특이한점은 2001년 9.11사태 이후 연방정부와 주정부의 상당한 예산 지원을 그랜트 지원금 형식으로 받아 연방, 주정부, 지방 정부, 의료 기관등에서 일사 불란하게 생물/화학/방사성 테러에 대비하는데 보건 교육사들은 시민 인지도 향상과 위기관리 컴뮤니케이션 영역에서 활약한다. 총체적인 보건 교육/건강 증진책은 다음 천년간 뉴저지 건강증진 백서와 미연방 정부 건강증진 2010에 준하여 설립한 뉴저지 건강 증진 2010 에 의한다. 그 모델을 보면; 1) 생활 습관 향상으로 위해 행위 절제; 적절한 영양 섭취 와 과체중화 차단 불필요한 투약 절제와 그 관리 흡연 탐익 절감, 금연, 흡연관련 신체/정신적 피해 관리/치료 습관성 약물 중독 조기발견 예방 낙상 예방 폭력, 의도적/비의도적 상해 예방 2) 심장질환, 암, 뇌졸중, 당뇨, 폐염, 인프루엔자등 주사망원인 질병 조기 발견 예방 책 마련; 독감.폐렴 예방 주사 실시 3) 보건 교육 대상과 표적 설정 특히 보건사업 참여 동반자 발굴하여 그 동참과 책임분담 책려; 주. 지방 정부기관, 의료 종사자, 의료 보험 업자, 대학 등 교육 기관, 연구 기관, 교육자, 지방 보건소, 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구., 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구.

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Development of Preliminary Quality Assurance Software for $GafChromic^{(R)}$ EBT2 Film Dosimetry ($GafChromic^{(R)}$ EBT2 Film Dosimetry를 위한 품질 관리용 초기 프로그램 개발)

  • Park, Ji-Yeon;Lee, Jeong-Woo;Choi, Kyoung-Sik;Hong, Semie;Park, Byung-Moon;Bae, Yong-Ki;Jung, Won-Gyun;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.113-119
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    • 2010
  • Software for GafChromic EBT2 film dosimetry was developed in this study. The software provides film calibration functions based on color channels, which are categorized depending on the colors red, green, blue, and gray. Evaluations of the correction effects for light scattering of a flat-bed scanner and thickness differences of the active layer are available. Dosimetric results from EBT2 films can be compared with those from the treatment planning system ECLIPSE or the two-dimensional ionization chamber array MatriXX. Dose verification using EBT2 films is implemented by carrying out the following procedures: file import, noise filtering, background correction and active layer correction, dose calculation, and evaluation. The relative and absolute background corrections are selectively applied. The calibration results and fitting equation for the sensitometric curve are exported to files. After two different types of dose matrixes are aligned through the interpolation of spatial pixel spacing, interactive translation, and rotation, profiles and isodose curves are compared. In addition, the gamma index and gamma histogram are analyzed according to the determined criteria of distance-to-agreement and dose difference. The performance evaluations were achieved by dose verification in the $60^{\circ}$-enhanced dynamic wedged field and intensity-modulated (IM) beams for prostate cancer. All pass ratios for the two types of tests showed more than 99% in the evaluation, and a gamma histogram with 3 mm and 3% criteria was used. The software was developed for use in routine periodic quality assurance and complex IM beam verification. It can also be used as a dedicated radiochromic film software tool for analyzing dose distribution.

Revision of The Korean Pharmceutical Codex, The Third Edition (의약품 등 기준 및 시험방법(제 3개정) 소개)

  • Choi, Myoeng-Sin;Yang, Ji-Sun;Yoo, Tae-Moo;Kim, In-Kyu;Kim, Hye-Soo;Lee, Sun-Hee;Chang, Seung-Yeup;Cho, Jung-Hee;Lee, Su-Jung;Kim, Young-Lim;Kim, Mi-Jeong;Kim, Eun-Jung;Lee, Jong-Pil;Kim, Do-Hoon;Baek, Kyung-Min;Kim, Hee-Sung;Park, Sang-Aeh;Kang, In-Ho;Kim, Eun-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.35 no.3
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    • pp.201-205
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    • 2005
  • The aim of publishing the Korean Pharmaceutical Codex is to update and set specification of essential drugs for humane health. In accordance with speedy development of new drugs and improvement of science and technology, the need of revision of drug specification through the ICH guidelines and discussions between regulatory agency and pharmaceutical industry for the quality assurance of safer and efficient drugs is getting higher. The first edition of Korean Pharmaceutical Codex was published in 1983. Now, the third revision of the Codex is prepared because of the revision of domestic and foreign Pharmacopeias, changes of drug control environment, improvement of science and technology and so on. The aim of 3th edition is to improve the quality of essential drugs through the setting of the required specifications and discussions between the regulatory agency and pharmaceutical industry.

Development of nutrition quotient for Korean preschoolers (NQ-P): Item selection and validation of factor structure (취학전아동 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Lee, Jung-Sug;Kang, Myung-Hee;Kwak, Tong-Kyung;Chung, Hae Rang;Kwon, Sehyug;Kim, Hye-Young;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.378-394
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    • 2016
  • Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

The Usefulness Assessment of Verifying Daily Output by Using CHECKMATE$^{TM}$ (CHECKMATE$^{TM}$를 이용한 일일 출력 검증의 유용성 평가)

  • Cho, Han-Sang;Nam, Sang-Soo;Park, Hae-Jin;Kim, Mi-Hwa;Park, An-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.51-58
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    • 2011
  • Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

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Case Study of Ancient City Wall Renewal in Gongju, a Historic Cultural City (역사문화도시 공주의 고도담장정비 사례 연구)

  • Ohn, Hyoungkeun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.254-269
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    • 2020
  • The purpose of this study is to propose guidance for wall renewal that is appropriate for an ancient city wall through application of advanced research and theories in wall design. It is a streetscape improvement project which forms part of the "Ancient City Image Finding Project". Study methods consist of advanced research classification, wall design theory contemplation, and analysis of the significance of designated ancient city areas and the "Ancient City Image Finding Project" status. Based on these methods, case study candidates were selected, case status and problems were identified, and improvement proposals were analyzed by comparing various features. Advanced wall research was classified into six categories including analysis of wall characteristics; wall design principle applications; wall structure, color, shape, and application; modern reinterpretation; palace walls; and house, temple, and village walls. The wall is an element of the streetscape improvement component of the "Ancient City Image Finding Project", with the characteristic of providing preceding experience in visual and cognitive awareness than interior structure. Case candidates for ancient city wall improvement are based on the composition distribution of the special conservation district in each ancient city as well as the conservation promotion district. Ultimately, the surrounding village of Gongju-si Geumseong-Dong Songsanri-gil, adjacent to the Royal Tomb of King Muryeong, was selected as the candidate. The "Ancient City Image Finding Project" of the surrounding village of Gongju-si Geumseong-Dong Songsanri-gil began with new Hanok construction. However, wall maintenance did not begin concurrently with that new Hanok construction. Support and maintenance took place afterwards as an exterior maintenance project for roadside structures. If the Hanok and wall were evaluated and constructed at the same time, the wall would have been built in unison with the size and design of the Hanok. The layout of the main building and wall of the Hanok is deemed to be a structure that is closed tightly because of its spatial proximity and tall height. Songsan-ri-gil's wall design should create a calm, subtle, and peaceful atmosphere with shapes, colors, and materials that express ancient city characteristics, but it is in an awkward position due to its sharpness and narrowness. The cause of the problem at Gongju-si Geumseong-dong Songsanri-gil, the case candidate, is that it is lacking significantly in terms of the aesthetic factors that traditional walls should possess. First, aesthetic consciousness seems to have disappeared during the selection and application process of the wall's natural materials. Second, the level of completion in design and harmony is absent. Maintenance guidance after analyzing the cause of problems in ancient city wall maintenance at Gongju-si Geumseong-dong Songsanri-gil, the subject area of research, is as follows: First, the Hanok design and layout of the wall and main gate should be reviewed simultaneously. Second, the one-sided use of natural stone wall in the Hanok wall design should be reexamined. Third, a permanent system to coordinate the opinions of citizens and experts during the planning and design phases should be employed. Fourth and finally, the Hanok's individuality shall be collectivized and its value as a cultural asset representing the identity of the community shall be increased.