• 제목/요약/키워드: CT practice

검색결과 148건 처리시간 0.025초

물리치료사의 업무범위와 의사의 지도권에 관한 법적 검토 - 청주지방법원 2010. 2. 3. 선고 2009노1317 판결 - (A Legal Review on Physical Therapists' Roles and Doctors' Superintendency)

  • 김한나;김계현
    • 의료법학
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    • 제11권2호
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    • pp.337-361
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    • 2010
  • In the case of Korea, both of modern medicine and oriental medicine are admitted as medical practices in the system. In other words, healthcare system is dualized. However, medical practice that corresponds to oriental medicine in Korea is substitution of medical practice in cases of foreign countries. For use of medical devices, it is provided only for doctors and medical technician relevant to use. Particularly, although oriental medicine is recognized as orthodox medicine in terms of the features of Korean medical system, superintendency of oriental doctors is not identical with that of doctors for use of medical devices and superintendency toward medical technicians. Recently, Cheongju District Court decided that superintendency of oriental doctor upon physical therapist is not acknowledged. It can be said that the judgement is opposed to the original verdict which judged that oriental doctors' employment and guidance of oriental doctors upon physical therapist is permissible. Hence this study aimed to review on domestic medical law system, which is dualized, roles of medical professionals, intent of the medical license system, provisions related to medical technician law and relevant precedents. Regulations on practices other than licensed practices by medical professionals are made because medical practices may affect on danger toward life and body of human and public health also. Therefore, the nation regulates medical professionals having licenses to perform medical practices within the range of the licenses. It is clearly prescribed that medical technicians may perform medical practices under instructions of doctors or dentists pursuant to the medical technician law. In addition, the court also judges that it is out of the license of oriental doctors if they use CT devices and limits the use of modern medical devices by oriental doctors. That is to say that it limits oriental doctors' employment of medical technicians and pursuant of oriental doctors on medical technicians as well.

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온톨로지에 기반한 간호진단 지식모델의 설계 (Design of Knowledge Model of Nursing Diagnosis based on Ontology)

  • 이인근;김화선;이성희
    • 한국지능시스템학회논문지
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    • 제22권4호
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    • pp.468-475
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    • 2012
  • 간호사는 NANDA, NIC, NOC과 같은 간호과정의 표준 가이드라인에 따라 간호 실무를 수행하고, 간호과정에 대한 정보를 전자의무기록 시스템에 기록하고 있다. 특히, NANDA는 간호진단 분류체계로써 간호진단의 추상적인 개념을 나타내고 있어, 상세한 간호진단 내용의 표현에 어려움이 있다. 그로 인해, 국내 병원에서는 자체적으로 간호진단 목록을 정의하여 사용하고 있으나, 이들은 표준이 적용되지 않아 간호기록의 전산화가 어려운 문제점이 있다. 따라서 본 논문에서는 NANDA와 SNOMED-CT와 같은 표준 용어체계를 참조하여 간호진단 개념을 표현하기 위한 온톨로지로 구축 방법론을 제시한다. 제안한 방법은 각 병원 및 분야에서 주로 사용하는 간호진단 목록을 체계적으로 구축함으로써 의료정보 시스템 간의 상호운용이 가능하고 지식의 확장이 용이하도록 한다. 제안한 방법에 따라 경북대학교병원의 여성건강 간호기록 진술문을 분석하고, 간호진단 정보의 추출 및 정련을 통해 112개의 간호진단 용어를 생성하였다. 그리고 이 용어를 이용하여 여성건강 간호진단 온톨로지를 구축하였고, 전문가 평가 및 실험을 통해 개발한 온토롤지의 타당도와 실용성을 확인하였다.

임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량 (Radiation Doses and Quality Assurance in Cone Beam CT(CBCT))

  • 최용석;김규태;황의환
    • 대한치과의사협회지
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    • 제52권3호
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

Improvement in metabolic parameters in obese subjects after 16 weeks on a Brazilian-staple calorie-restricted diet

  • da Costa, Teresa H.M.;Reis, Caio E.G.;da Silva, Fabio V.P.;Casulari, Luiz A.
    • Nutrition Research and Practice
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    • 제8권4호
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    • pp.410-416
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    • 2014
  • BACKGROUND/OBJECTIVES: The standard pattern of Brazilian food consumption is based on the combination of rice and beans served together in the main meals. This study assessed the effects of Brazilian-staple calorie-restricted (BS-diet) dietary advice, with brown rice and beans, on metabolic parameters, body composition, and food intake in overweight/obese subjects. SUBJECTS/METHODS: Twentyseven subjects were randomly assigned to a conventional-type calorie-restricted diet (CT-diet) (n = 13) or a BS-diet (n = 14). Glucose metabolism, lipid profile, anthropometric and body composition parameters, and food intake were measured before and after 16 weeks. Paired t-tests/Wilcoxon tests were used for comparison of differences from baseline and unpaired t-tests/Mann-Whitney tests were used for comparison of differences between the groups. RESULTS: After16 weeks, both groups showed reductions in weight and waist circumference (P < 0.02), and the BS-diet group showed a decrease in body fat (P = 0.0001), and significant improvement in glucose metabolism (fasting plasma glucose, glucose and insulin areas under the curve, Cederholm index, and HOMA2-$%{\beta}$) ($P{\leq}0.04$) and lipid profile (cholesterol, triacylglycerol, LDL-c, VLDL-c, and cholesterol/HDL-c ratio) ($P{\leq}0.05$). In addition, the BS-diet group showed significant improvement in HOMA2-$%{\beta}$, compared to the CT-diet group (P = 0.03). The BS-diet group also showed a significant reduction in energy, lipids, carbohydrate, and cholesterol intake ($P{\leq}0.04$) and an increase in fiber intake ($P{\leq}0.001$), while the CT-diet group showed a significant reduction in intake of energy, macronutrients, PUFA, and cholesterol ($P{\leq}0.002$). CONCLUSIONS: These results demonstrate the benefits of the BS-diet on metabolic parameters in obese subjects.

실험적으로 유발된 직장종양에 대한 치료적 초음파의 효과 (Effects of Therapeutic Ultrasound on Experimental Induced Rectal Sarcoma(CT-26))

  • 정미선;오명화;김계엽;김찬규
    • 대한물리치료과학회지
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    • 제11권3호
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    • pp.5-13
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    • 2004
  • The use of therapeutic ultrasound(US) in humans with malignant neoplasms has been contra-indicated in physical therapy practice. Some studies have shown the results after application of US inhibited of tumor growth but some studies have shown the results facilitated of tumor growth in mouse. The purpose of this study were to determine the effects of US on rectal sarcoma(CT-26) in mouse and to determine the histological change of tumor. Thirty-five female BALB/C mouse, age 6 to 8 weeks received subcutaneous injection of 0.1 105 tumor cells. When tumors grew to 5 mm in diameters, the mouse were randomly assigned to control group(n=7) and high powered continuous US group(n=7) and low powered continuous US group(n=7) and high powered pulsed US group(n=7) and low powered pulsed US group(n=7). The experimental group (four groups) received 10 treatments over a 10-day period of 3 MHz ultrasound. Tumor dimension were measured on days 1(start of treatment), 5(midtreatment), and 10(end of treatment, preexcision and postexcision). Tumors were weighed after excision and the mouse were observated histological change of tumor. All tumors grew larger over time. Mean tumor weights(in grams) and volumes(in cubic millimeters) were 2.063 g and $2729.313\;mm^3$ for the high powered continuous US group 1.881 g and $2428.002\;mm^3$ for the low powered continuous US group 1.730 g and $2381.002\;mm^3$ for the high powered pulsed US 1.673 g and $2289.562\;mm^3$ for the low powered pulsed US group 1.670 g and $2297.333\;mm^3$ for the control group. Ultrasound increased the weight and volume of subcutaneous tumor in mouse. We urge caution in the use of ultrasound in the areas of tumors.

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Retreatability of two endodontic sealers, EndoSequence BC Sealer and AH Plus: a micro-computed tomographic comparison

  • Oltra, Enrique;Cox, Timothy C.;LaCourse, Matthew R.;Johnson, James D.;Paranjpe, Avina
    • Restorative Dentistry and Endodontics
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    • 제42권1호
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    • pp.19-26
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    • 2017
  • Objectives: Recently, bioceramic sealers like EndoSequence BC Sealer (BC Sealer) have been introduced and are being used in endodontic practice. However, this sealer has limited research related to its retreatability. Hence, the aim of this study was to evaluate the retreatability of two sealers, BC Sealer as compared with AH Plus using micro-computed tomographic (micro-CT) analysis. Materials and Methods: Fifty-six extracted human maxillary incisors were instrumented and randomly divided into 4 groups of 14 teeth: 1A, gutta-percha, AH Plus retreated with chloroform; 1B, gutta-percha, AH Plus retreated without chloroform; 2A, gutta-percha, EndoSequence BC Sealer retreated with chloroform; 2B, gutta-percha, EndoSequence BC Sealer retreated without chloroform. Micro-CT scans were taken before and after obturation and retreatment and analyzed for the volume of residual material. The specimens were longitudinally sectioned and digitized images were taken with the dental operating microscope. Data was analyzed using an ANOVA and a post-hoc Tukey test. Fisher exact tests were performed to analyze the ability to regain patency. Results: There was significantly less residual root canal filling material in the AH Plus groups retreated with chloroform as compared to the others. The BC Sealer samples retreated with chloroform had better results than those retreated without chloroform. Furthermore, patency could be re-established in only 14% of teeth in the BC Sealer without chloroform group. Conclusion: The results of this study demonstrate that the BC Sealer group had significantly more residual filling material than the AH Plus group regardless of whether or not both sealers were retreated with chloroform.

Dicom file을 이용하여 만든 신체 맞춤형 3D print 손가락 보조기 제작 (Produced Body Customized 3D Print Finger Brace using Dicom File)

  • 최현우;박지은;김정훈;서안나;이종민
    • 한국방사선학회논문지
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    • 제13권4호
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    • pp.597-603
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    • 2019
  • 임상에서 사용하는 진단 검사 장치인 전산화 단층촬영기(CT)를 이용하여 Dicom 파일을 획득하였습니다. Dicom 파일과 3D 프로그램, 3D 프린터로 손가락 보조기(Finger brace)를 제작하였습니다. 손가락 보조기(Finger brace)는 인체를 대상으로 하기 때문에 형태의 정밀도가 매우 중요합니다. 3D Print는 정밀도가 우수하고, 재료가 다양하고, 출력 시간이 짧은 이점이 있습니다. 임상에서는 알루미늄 보호대나 의료기 업체의 손가락 보호대가 한정적입니다. 3D 프린터로 손가락 보조기(Finger brace)를 제작하면, 환자의 손가락 외상, 질병, 변형의 치료에 이용할 수 있는 정밀한 형태의 맞춤형 손가락 보조기(Finger brace)를 환자에게 적용할 수 있을 것이라고 기대합니다.

Comparison of limited- and large-volume cone-beam computed tomography using a small voxel size for detecting isthmuses in mandibular molars

  • de Souza Tolentino, Elen;Andres Amoroso-Silva, Pablo;Alcalde, Murilo Priori;Yamashita, Fernanda Chiguti;Iwaki, Lilian Cristina Vessoni;Rubira-Bullen, Izabel Regina Fischer;Duarte, Marco Antonio Hungaro
    • Imaging Science in Dentistry
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    • 제51권1호
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    • pp.27-34
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    • 2021
  • Purpose: This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. Materials and Methods: Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). Results: The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat(P<0.05). Conclusion: Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.

영상유도 및 호흡동조 방사선치료에서의 영상장비에 의한 흡수선량 분석 (Analysis of the Imaging Dose for IGRT/Gated Treatments)

  • 신정석;한영이;주상규;신은혁;홍채선;안용찬
    • Radiation Oncology Journal
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    • 제27권1호
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    • pp.42-48
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    • 2009
  • 목적: 영상유도방사선치료(IGRT)와 호흡동조방사선치료(4DRT)의 도입은 치료계획 및 치료부위 확인에서 환자에게 방사선 조사량을 증가시킬 가능성이 있다. 따라서 IGRT/4DRT용 영상장비와 기존 장비에서 영상선량을 측정 및 비교하였다. 대상 및 방법: IGRT 및 4DRT를 위해 새로이 도입된 4DCT (GE, Ultra Light Speed 16)와 모의치료기(Varian Acuity), 그리고 치료기(Varian IX)에 장착된 kVp (OBI)의 영상장비 및 EPID (aSi 1000)를 대상으로, RANDO 팬톰의 표면 선량을 측정하여 기존의 장비들(single slice CT (GE, Light Speed), 모의치료기(Varian, Ximatron), L-gram (Varian 2100C))과 비교하였다. 측정은 열형광선량계를 이용하여 두뇌부, 눈, 갑상선, 흉부, 복부 및 골반부의 표면에서 측정하였다. 결과: 기존 CT와 비교하여 4DCT모드에서는 흉부와 복부에서 10배 이상의 선량증가를 보였다($1.74{\pm}0.34$ vs $23.23{\pm}3.67$ cGy). Acuity에서의 선량은 모든 측정부위에서 Ximatron보다 감소하였다($0.91{\pm}0.89$ vs $6.77{\pm}3.56$ cGy). EPID는 기존 L-gram 선량의 약 50% ($1.83{\pm}0.36$ vs $3.80{\pm}1.67$ cGy)였다. OBI의 투시영상선량은 $0.97{\pm}0.34$ cGy며, CBCT 선량은 $2.3{\pm}0.67$ cGy였다. 결론: 4DCT가 선량증가의 가장 큰 원인이며, OBI와 CBCT에 의한 선량은 적으나 매번 치료에 적용 시 총 선량 증가에 대한 고려가 필요하다.

CT상 악성여부가 불명확한 단일 폐결절에서의 양전자방출단층촬영술의 유용성 (Role of PET in Evaluating Indeterminate Solitary Pulmonary Nodule with CT)

  • 윤석부;최준영;김선정;최용;최연성;이경한;김상은;권오정;이경수;김병태
    • 대한핵의학회지
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    • 제31권1호
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    • pp.83-89
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    • 1997
  • CT에서도 악성 여부가 불명확한 단일 폐결절의 감별진단에 있어 PET이 어떠한 도움을 줄 수 있는지 알아보고자 이러한 환자 30명을 대상으로 FDG-PET을 시행하여 각 환자에서 구한 pSUV, aSUV, TAC 양상, 50/10비의 4가지 매개변수를 조직검사결과와 비교하여 다음과 같은 성적을 얻었다. 1) 4가지 매개변수의 악성판정 기준치로 $pSUV{\geq}3.5$, aSUV>2.5, TAC=상향, 50/10비${\geq}1.45$를 적용하였을 때 악성판정에 있어 각각의 예민도는 86.7%, 66.6%, 86.7%, 73.3%였으며, 특이도는 86.7%, 86.7%, 46.7%, 86.7%였다. 2) 4가지 매개변수중 구하기 용이한 점과 정확도를 감안할 때 임상적으로 pSUV가 가장 유용하였다. 3) pSUV를 사용하였을 경우 CT에서 불확실한 단일 폐결절의 87%에서 정확한 진단이 가능하였다. 4) 기관지 폐포암을 제외할 경우 예민도가 100%였다. 이상의 결과에서 FDG-PET에서 구한 pSUV는 여러 가지 매개변수중 가장 용이하게 구할 수 있으며 비 침습적으로 단일 폐결절의 악성여부를 가릴 수 있는 유용한 방법이었다.

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