• The Korean Society of Law and Medicine
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• v.21 no.3
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• pp.3-33
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• 2020

Telemedicine can be defined as "medical activities performed remotely by medical personnel using information and communication technology." So far, many scholars in Korea have understood that only telemedicine between medical personnel is allowed and telemedicine between medical personnel and patients is prohibited based on Article 34 of Medical Service Act. However, Article 34 is only a restriction on the performing place of medical profession, not a prohibition on telemedicine itself. And, there are no regulations prohibiting telemedicine under the korean medical law. So, it is difficult to say that telemedicine is generally prohibited under the korean medical law, apart from the health insurance medical treatment benefit standards. However, there is controversy in interpretation regarding the meaning of "direct diagnosis" in Articles 17 and 17-2 of Medical Service Act. The Constitutional Court of Korea interpreted this as "face-to-face diagnosis", while the Supreme Court of Korea interpreted it as "self diagnosis". In light of the dictionary meaning of 'direct' and the interpretation of related medical law regulations, I think the Supreme Court's interpretation is valid. Although "direct diagnosis" does not mean "face-to-face diagnosis", the concept of "diagnosis" implies "principle of face-to-face diagnosis". In addition, "non-face-to-face diagnosis" are only allowed to supplement "face-to-face diagnosis", so the problems caused by "non-face-to-face diagnosis" can be fully overcome. In the end, the limit of telemedicine is how faithful the diagnosis was.

• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.3-33
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• 2022

In relation to telemedicine in Korea's medical law, there are Articles 17, 17-2, and 34 of the Medical Act. Since 'direct examination' in Articles 17 and 17-2 of the Medical Act can be interpreted as 'self-examination' rather than 'face-to-face examination', it is difficult to see the above regulation as a regulation prohibiting telemedicine. Prohibiting telemedicine only with the concept of medical examination or the 'principle of face-to-face treatment' is against the principle of "nulla poena sine lege"(the principle of legality). However, in order to qualify as 'examination', it must be faithful enough to replace face-to-face examination, so issuing a medical certificate or prescription after a poor examination over the phone is considered a violation of the Medical Act. In that respect, the above regulation can be said to be a regulation that indirectly limits telemedicine. On the other hand, most lawyers interpret that telemedicine between medical personnel and patients is completely prohibited based on Article 34, and the Supreme Court recently ruled that such telemedicine is not permitted even if there is a patient's request. However, this interpretation is not only far from the legislative intention at the time when telemedicine regulations were introduced into the Medical Act of 2002, but also does not match the needs of reality or the legislative trend of foreign countries. The reason is that telemedicine regulations are erroneously legislated. The premise of the legislation is wrong, and there are considerable problems in the form and content of the legislation. As a result, contrary to the original legislative intent, telemedicine was completely banned. In foreign countries, it is difficult to find cases where telemedicine is completely banned and criminal punishment is imposed for it. In order to fundamentally solve the problem of telemedicine, Article 34 of the Medical Act needs to be deleted.

• The Korean Society of Law and Medicine
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• v.22 no.1
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• pp.3-23
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• 2021

Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

• Proceedings of the KIEE Conference
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• 2008.07a
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• pp.1989-1990
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• 2008

한의학에서 맥진은 한의사가 손가락으로 환자의 손목의 요골동맥을 짚어 맥박이 손가락에 닿는 느낌에 근거하여 병세를 감별하는 진찰방법으로 인체의 건강상태를 살피고, 정상인의 평맥(平脈)으로부터 환자의 병맥(病脈)을 분석하는 진단법이다. 손목에 있는 요골 경상돌기(styloid preocess) 부근의 볼록한 지점을 고골(高骨)이라하는데 이 돌기를 기준으로 맥이 느껴지는 위치를 검지, 중지, 약지를 이용해 진맥위치를 잡는다. 맥진 시 한의사는 맥진위치에 압력을 서서히 가하면서 손끝에 느껴지는 감각을 이용해 진단한다. 이 과정에서 맥진위치 요골동맥의 혈관이 서서히 occlusion 된다. 본 논문에서는 맥진과정 시 요골동맥의 혈류역학적인 변화를 초음파를 이용해 분석해보고자 한다. 건강한 남자 피험자(34세)를 대상으로 초음파 장비(Voluson 730Pro, GE Medical, U.S.)를 이용해 맥진 위치의 혈관특성을 관찰한다. 혈압계를 이용해 혈관에 압력을 0에서 130mmHg까지 10mmHg씩 단계별로 가압한 후 초음파를 측정한다. 그 결과, 요골동맥에 압력을 가할수록 혈류속도가 서서히 감소함을 알 수 있었으며, 회귀식을 분석할 수 있었다(y = -0.3509x +44.323, $R^2$ = 0.9547). 또한, 가압 단계를 0$\sim$10mmHg, 20$\sim$40mmHg, 50$\sim$70mmHg, 80$\sim$100mmHg 110$\sim$130mmHg으로 가압단계를 나누어 보면, 각 단계별로는 42.32cm/sec, 33.08cm/sec, 24.8cm/sec, 14.3cm/sec, 0cm/sec로 혈류속도가 변화를 보였다. 각 단계별로 혈류속도가 평균 10.58cm/sec의 차이를 보임을 알 수 있다. 본 연구를 통해 가압력에 대한 맥진위치의 혈류변화를 관찰하였다. 그러나 직접 맥진위치를 가압하면서 초음파를 통해 혈류속도를 측정할 수 있는 방법이 없어, 맥진 위치 바로 위쪽을 가압하고 초음파 측정을 하였다. 직접 혈관을 가압하고 그때의 혈류속도를 측정하면 보다 정확히 맥진시의 혈류역학적 특성을 분석할 수 있을 것으로 판단된다. 장비의 고안을 통해 다음 연구에서는 직접적인 가압 후 혈슈속도를 측정해 봄으로써 본 결과와 비교 분석해 보고자 한다.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.49-80
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• 2013

The Issuance of false medical certificates on Criminal Law or the Medical Service Act are frequently applied to the insurance fraud cases related with the medical certificate, prescriptions. The meaning of medical certificate is not defined on the crime of Issuance of false medical certificates, but considering the rule of Paragraph 1 of Article 17 of the Medical Service Act, which punishes drawing up the medical certificate by anyone except the doctor who has directly examined, and the principle of legality, the medical certificate applied with the crime of Issuance of false medical certificates should (1) include the judgment after current medical ex-amination, (2) be written for the purpose of verifying the health status and (3) have a style that can be recognizable as medical document usually written by doctors. In addition, since there have been many argues on the range of application of the Paragraph 1 of Article 17 of the Medical Service Act, which generally regulates various kinds of documents such as medical certificates, prescriptions and others, which have different purpose and characters, the range of application of the clause above is needed to be interpreted strictly.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.68-71
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• 2008

Septic encephalopathy is defined as brain dysfunction secondary to sepsis. It occurs in septic patients as a manifestation of multi-organ dysfunction. Without evidence of intracranial infection, various extracranial infections causing severe sepsis may induce septic encephalopathy. We report a patient with septic encephalopathy complicating acute appendicitis. Initially, the patient presented with impaired mental state and raised liver enzymes.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 2005.04a
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• pp.386-389
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• 2005

우리나라는 노령화사회로 진행되어 감에 따라 노인성 만성질환이 증가하는 추세이다. 특히 노인성 만성질환 중 전립선비대증 질환의 경우 지속적인 관리가 필요한 질환이다. 전립성비대중의 경우 생명에 큰 지장이 없으면서 주기적으로 자주 의사를 찾아야 하는 번거로움이 있고, 또한 진단 및 투약결정이 상대적으로 복잡하지 않은 질환이다. 이 논문에서는 모바일 단말기를 이용하여 환자가 자신의 관찰데이터를 병원에 전송하도록 하고, 병원의 환자관리시스템에서 분석을 통해 환자를 모니터링하면서 의사의 직접진찰 시기를 조정할 수 있도록 설계된 전립선만성질환 환자에 대한 관리시스템에 대해서 소개한다.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.236-239
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• 2016

$Guillain-Barr{\acute{e}}$ syndrome (GBS) is caused by antecedent infectious diseases in approximately two-thirds of cases. GBS is considered an autoimmune response. Among reported preceding infections, influenza virus is relatively rare. Several reports have identified antibodies related to GBS pathogenesis. However, no case report has described the detection of influenza virus in the cerebrospinal fluid (CSF) of a patient with GBS by polymerase chain reaction (PCR). Here we report the case of a 6-year-old girl who was diagnosed with influenza A 1 week prior and was treated with oseltamivir, after which she visited our hospital for headache and bilateral leg weakness that had persisted for 1 day. We diagnosed her with GBS based on physical and neurologic examination findings, CSF analysis, nerve conduction velocity test results, spinal magnetic resonance imaging, and detection of influenza A virus in her CSF by PCR. She was treated with intravenous immunoglobulin and her symptoms slowly improved. This case report suggests that GBS may be caused by influenza virus through penetration of the CSF.

• Journal of Advanced Navigation Technology
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• v.27 no.1
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• pp.139-145
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• 2023

When a doctor examines a patient in a hospital, the doctor directly checks the patient's condition and conducts a face-to-face diagnosis through dialogue with the patient. However, it is often difficult for doctors to directly treat patients. Recently, several types of telemedicine systems have been developed. However, the systems have lack of capabilities to observe heart disease, neck condition, skin condition, inside ear condition, etc. To solve this problem, in this paper, an interactive telemedicine robot system with autonomous driving in a room capable of visual examination and auscultation of patients is developed. The developed robot can be controlled remotely through the WebRTC platform to move toward the patient and check a patient's condition under the doctor's observation using the multi-joint robot arm. The video information, audio information, patient's heart sound, and other data obtained remotely from patients can be transmitted to a doctor through the web RTC platform. The developed system can be applied to the various places where doctors are not possible to attend.

• The Journal of Korean Medical History
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• v.27 no.1
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• pp.9-13
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• 2014

연구목적 : 조선(朝鮮) 왕실자녀(王室子女)의 출산과정을 일지(日誌) 형식으로 기록한 "호산청일기(護産廳日記)"는 후기 조선(朝鮮)의 임산(臨産)과 분만, 산후 및 신생아 증상에 대한 의학적 처치 및 산실배설(産室排設)과 출산의례를 고찰할 수 있는 가치 있는 의학사료(醫學史料)이다. 연구방법 : 1. "호산청일기(護産廳日記)"에 기록된 세 번의 출산에 대해 출산 전후 산부(産婦)와 신생아의 실제 상황과 증상, 의관(醫官)의 판단과 치법(治法), 처방(處方)내용, 치료경과 등 의학적 처지의 내용을 살펴봄으로써 당시 산과의학(産科醫學)의 경향성, 발달정도 등을 가늠해보았다. 2. "호산청일기(護産廳日記)"에 기록된 세 번의 출산에 대해 조선왕실(朝鮮王室)의 출산형식 및 관련의례에 드러난 당시 의학의 출산에 대한 의철학(醫哲學)이 어떠하였는지 고찰하였다. 결과 및 결론 : 산전(産前) 의관(醫官)의 정기문진으로 산모와 의사 간 관계형성 및 산부(産婦)의 안정을 도모하였으며, 의녀(醫女)의 진찰소견을 의관(醫官)이 판단하여 처방하였다. 임산(臨産)에 불수산(佛手散)과 인삼차(人蔘茶), 산후어혈증(産後瘀血症)에 가미궁귀탕(加味芎歸湯)을 빈용(頻用)하였으며, 화반곽탕(和飯藿湯)의 식치(食治)가 주요 산후조리법이었다. 신생아의 구급(救急)에 특히 우황(牛黃)을 빈용(頻用)하고 증상에 따라 유모(乳母)가 복약(服藥)하기도 하였으나, 조산(早産)된 신생아의 청색증(靑色症)(cyanosis)으로 보이는 증후(症候)와 사망례(死亡例)가 보인다. 산실배설(産室排設) 및 현초(懸草), 권초제(捲草祭) 등 관련의례에는 출산을 '하늘과 직접 소통하는 하나의 의례(儀禮)'로 생각하여 외부 환경의 방해 없이 산부(産婦)와 신생아의 천계(天癸)가 잘 작동하도록 배려한 의철학(醫哲學)이 드러나 있다.