• Proceedings of the Korean Society of Broadcast Engineers Conference
• /
• 2014.06a
• /
• pp.221-222
• /
• 2014

병원이 가깝지 못해서 혹은 사정이 넉넉하지 못해서, 혹은 병원에 갈 상황이 되지 못해서 병원에 가지 못하는 많은 사람들을 위해서는 보다, 환자의 입장에서 편리한 방법으로 진료를 하거나, 혹은 자가 치료, 자가 진단을 할 수 있는 교육이 필요하다. 그와 같은 원격의료를 하기 위해서는 의료가 실시 되는 기기의 수용의도가 중요하다고 판단된다. 본 연구에서는 원격의료를 위한 사용자(환자) 수용의도를 높이기 위해 요인관계를 분석하기 위하여 실시하였다. 총 299명에 설문에 참여하였으며, 15세~20세: 58명, 30대:86명, 40대:96명, 50대:59명이 참석하였으며 기술수용모델을 적용하였다. 연구는 원격의료에 사용되어지는 것이 가능한 양방향서비스기기 -IPTV, PC, 스마트폰(패드포함)-을 대상으로 진행되었으며, 연령 및 성별에 따라 사용의도가 크게 차이가 남을 확인할 수 있었다. 또한 매체자체에 대한 사용의도가 원격의료 수용의도에 큰 영향을 줌을 확인할 수 있었다.

• Review of KIISC
• /
• v.17 no.5
• /
• pp.32-39
• /
• 2007

언제 어디서나 예방, 진단, 치료, 사후 관리의 보건 의료 서비스를 제공하는 Ubiquitous-Healthcar(U-HC)는 최근 초보적인 단계로 IT기술과 의료 시스템이 결합된 원격 또는 재택 진료 시스템이 선을 보이고 있다. 하지만 원격 의료 시스템의 개인 신상 및 바이오 유출은 환자의 프라이버시 침해의 가능성을 내포하고 있다. 따라서 본고에서는 원격 의료 정보 시스템의 인증을 강화하기 위하여 Telebiometrics X.tsm과 X.tai 표준을 기반으로 하는 바이오 인식 기반 원격의료 정보 시스템의 사용자 인증 모델의 예를 제시하고 Telebiometrics의 X.tpp를 기반으로 시스템에서 발생 할 수 있는 취약성 및 위협을 분석한다.

• Proceedings of the Korea Information Processing Society Conference
• /
• 2008.05a
• /
• pp.447-450
• /
• 2008

해상에서 장시간 운행하는 선박에서 사고나 질환이 발생 할 경우, 원격지의 의사와 단순한 문답으로 환자의 치료를 하거나 간단한 조치 밖에 하지 못하지만 국제해상위성을 이용하여 원격지의 의사가 원격진료가 가능한 시스템의 데이터 통신을 설계, 구현한다. 원격진료 시스템은 응급상황 발생시 항해 중이었던 선박을 회항하거나 하는 경우를 예방할 수 있어 상당한 비용절감의 효과가 있으리라 판단되며, 선박에서 전화통신의 용도로 사용하던 기존의 해사위성 망을 이용하여 낮은 전송속도에서 중요한 의학적 정보를 효율적으로 전송할 수 있는 통신 시스템을 설계하고 구현 한다.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2003.09a
• /
• pp.40-40
• /
• 2003

목적 : 현재 국내에서 사용중인 Co-60 원격치료용 방사선 조사장치의 경우 tissue air ratio(TAR)는 조사 표면에서 최대 선량을 가지는 back scatter factor(BSF)를 적용하여 구한 값을 사용하고 있는데, 실제로 Co-60 원격치료용 방사선 조사장치의 최대선량 깊이는 조사 표면이 아니라, 조사 표면에서 0.5cm 떨어진 거리에서 최대 선량을 나타내므로, BJR 25 에서 권장하는 값인 peak scatter factor(PSF)를 이용해 구한 값이 더 정확한 값으로 사료되기 때문에 이를 본 실험을 통해 검증하고자 하였다. 대상 및 방법 : 방사선 종양학과에서 치료용으로 사용하고 있는 Co-60 원격치료용 방사선 조사장치를 대상으로 하였다. BSF 는 Khan이 저술한 The Physics of Radiation Therapy의 부록에 제시된 값을 사용하였으며, PSF와 TAR를 구하기 위해 물 팬톰(water phantom), Farmer형 이온 챔버(ion chamber), 전기계(electrometer)를 사용하였다. PSF와 TAR를 구하기 위해서 몇 가지 측정을 하였다. 먼저, 공기 중에서 챔버를 SSD=80.5cm에 고정시킨 후, 방사선을 조사하여 선량을 측정하고, 깊이에 따른 선량을 알아보기 위해, 물 팬톰 내에 챔버를 SSD=80cm 고정시킨 후, 물을 서서히 채워가면서 5$\times$5cm, 10$\times$10cm, 15$\times$15cm, 20$\times$20cm, 30$\times$30cm의 field size에 대해서, 물의 깊이가 0.5cm-2cm 까지는 0.5cm 단위로 선량을 측정하고, 물의 깊이가 2cm-l4cm까지는 1cm단위로 선량을 측정하였다. 측정된 선량을 이용하여 PSF를 구하고 난 후, BJR 25에서 제시한 PSF와 비교를 하였고 TAR은 Khan이 제시한 변환식에 PSF를 대입하여 알아보았다. 기존의 TAR과 PSF를 이용해 구한 TAR을 측정하여 구한 TAR과 비교하였다. 결과 : BJR25에서 제시한 PSF와 본 실험에서 측정하여 얻은 PSF를 비교한 결과, field size가 5$\times$5cm, 10$\times$10cm, 15$\times$l5cm, 20$\times$20cm인 경우, 측정하여 얻은 PSF가 0.8%, 0.2%, 0.4%, 0.2%로 약간 높지만, 두 값은 매우 유사한 것으로 나타났다. 그리고, 기존의 BSF를 이용해 구한 TAR과 BJR 25에서 권고하는 PSF를 이용해 구한 TAR을 비교한 결과 field size 에 따라 약 1%-1.5% 정도로 BSF를 이용하여 구한 TAR보다 PSF를 이용하여 구한 TAR이 1.3% 정도 높게 나타났지만, 이것은 두 값의 절대적인 차이일 뿐, 실제로는 PSF를 이용하여 구한 TAR이 측정해서 구한 TAR과는 매우 유사한 값을 보여주고 있다. 결론 : 기존의 BSF를 이용해 구한 TAR과 PSF를 이용해 구한 TAR을 비교하였을 때, 약 1.3% 정도 높게 내고 있지만, 기존의 TAR보다는 PSF를 이용해 구한 TAR이 BJR 25와 잘 일치하고 있으므로 Co-60 원격치료용 방사선 조사장치를 사용할 경우 BSF보다는 PSF를 사용하는 것이 타당한 것으로 사료된다.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.283-289
• /
• 1998

Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed by radiation therapy in locally advanced non-small cell lung cancer Materials and Methods : Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine Patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. Results : Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). Conclusion : In stage III non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.

• Radiation Oncology Journal
• /
• v.14 no.1
• /
• pp.25-31
• /
• 1996

Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to Postoperative radiotherapy in resectable rectal cancer. Materials and Methods : Between January 1989 and Mar 1994, 60 patients with resectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital. Fifty one patients were available for analysis: 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with Postoperative radiotherapy. In sandwich technique radiotherapy(RT), Patients were treated with preoperative RT 1500 cGy/5fx, followed by immediate curative resection. Patients staged as Astler-Coiler B2, C were considered for postoperative RT with 2500-4500 cGy. in postoperative RT total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-Sweets was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich RT group and postoperative RT group were $60\%$ and $71\%$, respectively(p>0.05). The 5-rear disease free survival rates for each group were $63\%$. There was no difference in local failure rate between two groups($11\%$ versus $7\%$) Incidence of distant metastasis was $11\%$(2/20) in the sandwich technique RT group and $20\%$(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of Postoperative RT alone group but reduced distant metastasis compared to Postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT.

• Radiation Oncology Journal
• /
• v.24 no.3
• /
• pp.164-170
• /
• 2006

[ $\underline{Purpose}$ ]: This study identified the result of postoperative radiation therapy and the prognostic factors to affect survival rates in cancer patients. $\underline{Materials\;and\;Methods}$: One hundred and thirty three patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between June 1985 and November 2002 were retrospectively analyzed. One hundred and thirteen patients had stage IB disease, and 20 patients had stage IIA disease. Histological examination revealed 118 squamous cell carcinoma patients and 15 adenocarcinoma patients. Sixty seven patients were noted to have stromal invasion greater than 10 mm, and 45 patients were noted to have stromal Invasion 10 mm or less. Positive lymphovascular invasion was found in 24 patients, and positive pelvic lymph nodes were noted in 39 patients. Positive vaginal resection margin was documented in 8 patients. All of the patients were treated with external beam radiation therapy to encompass whole pelvis and primary surgical tumor bed. Intracavitary radiation therapy was added to 19 patients who had positive or close surgical margins. $\underline{Results}$: Actuarial overall and disease-free survival rates for entire group of the patients were 88% and 84% at 5 years, respectively. Five-year disease-free survival rates for patients with stromal invasion greater than 10 mm and 10 mm or less were 76% and 97%, respectively (p<0.05). Also there was a significantly lower survival in patients with positive pelvic lymph nodes compared with patients with negative pelvic lymph nodes (p<0.05). However, lymphovascular invasion, positive vaginal resection margins were not statistically significant prognostic factors. Addition of neoadjuvant chemotherapy or type of surgery did not affect disease-free survival. $\underline{Conclusion}$: Postoperative radiation therapy appears to achieve satisfactory local control with limited morbidity in cervical cancer patients with high pathologic risk factors. Distant metastasis was a dominant failure pattern to affect survival in cervical cancer patients after radical surgery and radiation and more effective systemic treatment should be investigated in these high-risk patients.

• Radiation Oncology Journal
• /
• v.26 no.3
• /
• pp.149-159
• /
• 2008

Purpose: To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial cancer, pelvic control, and overall survival rate was free of severe toxicity when pelvic radiation therapy or vaginal brachytherapy was performed. In the high-risk group, pelvic control rate was excellent, but the survival rate was poor due to distant metastases, in spite of the pelvic radiation therapy. The combined modality of chemotherapy and radiation therapy is recommended for high-risk groups. For the intermediate-risk group, a prospective randomized study is required to compare the efficacy between whole pelvic radiation therapy and vaginal brachytherapy.

• Radiation Oncology Journal
• /
• v.15 no.2
• /
• pp.105-111
• /
• 1997

group($22\%\;vs.\;38\%$, p=0.24). The 5YSRs of 21 patients of primary tumor extension to adjacent sites and the other 13 patients of tonsillar proper site were $28\%\;and\;38\%$, respectively but the difference was not significant statistically(p=0.52) There was a statistically significant difference in 5YSRs between the groups of the Patients who received radiotherapy in less than 61days vs more than 60days($60\%\;vs.\;18\%$, p=0.027). All living Patients without any tumor progression(n=11) had suffered from serious late sequelae such as xerostomia, edentia, dental caries and one patient had the osteoradionecrosis of mandible. On univariate analysis. the duration of radiotherapy and T-stage were the significant prognostic factors affecting 5YSR. On multivariate analysis, also the duration of radiotherapy was the only significant Prognostic factor(p=0.01). Conclusion : There was no survival difference between the radiotherapy alone and with neoadiuvant chemothe groups. Although it was a retrospective study, the role of conventional radiotherapy alone could be effective as the local treatment modality only for the early stage of tonsillar carcinomas. But for the purpose of more improved survivals and better quality of lives of living patients, other altered fractionation such as hyperfractionated radiotherapy with shorter treatment time and smaller fraction size rather than conventional radiotherapy might be beneficial and these prospective studies are needed.

• Radiation Oncology Journal
• /
• v.15 no.3
• /
• pp.251-254
• /
• 1997

Purpose : Simple hysterectomy is not a standard surgery for invasive cervical carcinoma. This study was performed to investigate the efficacy of radiotherapy following simple hysterectomy in the invasive cervical cancer. Materials and Methods : Retrospective analysis was done for 19 patients with invasive cervical carcinoma who were treated with radiotherapy following simple hysterectomy from April 1989 to December 1993 The median a9e of patients was 47 years old. Patients were treated with external beam radiation therapy alone (17) or external beam radiation therapy plus intra vaginal ovoid irradiation (2). The median follow up period was 46 months. Results : The 4 year overall survival rate was $75\%$. The 4 rear local control rate was $89\%$. Two patients had recurred at the locoregional and distant sites, and another two patients at distant sites. Conclusion : We confirmed that radiotherapy is the adequate treatment modality for patients with invasive cervical cancer who underwent simple hysterectomy.