• 의료법학
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• 제24권3호
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• pp.125-153
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• 2023

대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결은 한의사의 진단용 의료기기 사용이 면허된 것 이외의 의료행위에 해당하는지를 판단하는 새로운 기준을 제시하고, 이 기준에 따라 한의사의 초음파 사용을 무면허 의료행위가 아니라고 판단하였다. 대법원 2023. 8. 18. 선고 2016두51405 판결은 새로운 판단기준을 적용하여 뇌파계를 파킨슨병과 치매 진단에 사용한 행위가 한의사로서 면허된 것 이외의 의료행위에 해당하지 않는다고 판단한 첫 번째 사안이다. 대법원은 판례변경을 통해 의료기기 사용에 서양 의학적 지식과 기술이 필요하지 않아야 한다는 종전 기준을 폐기하였지만, 진단용 의료기기를 사용한 한의사의 서양 의학적 진단행위를 진단의 보조수단으로 볼 것인지는 불투명한 상태였다. 이에 대법원은 뇌파계를 활용하여 파킨슨병과 치매, 즉 서양 의학적 진단을 한 한의사의 행위를 면허된 것 이외의 의료행위가 아니라고 판단함으로써 진단의 보조수단이 가지는 의미를 명확히 정리하였다. 이외에도 대상 판결은 뇌파계의 개발, 제작 원리와 뇌파계 검사 결과의 자동 추출 및 자동 판독 여부 또한 판단기준에서 배제함으로써 한방의료행위의 의미가 수범자인 한의사의 관점에서 명확하고 엄격하게 해석되어야 한다는 죄형법정주의 관점을 더욱 투철하게 적용하고 진단용 의료기기가 한의학적 의료행위 원리와 관련 없음이 명백한 경우가 아닌 한 형사처벌 대상에서 제외됨을 분명히 하였다.

• 치과방사선
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• 제29권1호
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• pp.223-239
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• 1999

Purpose: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. Materials & Methods: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. Results: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). Conclusion: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.

• 대한임상검사과학회지
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• 제54권2호
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• pp.79-94
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• 2022

COVID-19로 인한 높은 전염성과 호흡기 질환의 심각성 때문에, 전염의 확산을 더 잘 모니터링하고 예방하기 위해 경제적이고 정확한 검사가 필요하다. COVID-19 대유행의 초기 단계에서 SARS-CoV-2의 구조적 및 분자적 특성이 밝혀짐에 따라, 많은 COVID-19 진단 키트 제조업체들은 진단 테스트의 설계, 개발, 검증 및 구현에 적극적으로 투자했다. 현재, SARS-CoV-2에 대한 진단검사로써 신속한 항원, 특정 IgG 및 IgM 항체검사를 위한 면역 혈청학적 검사 그리고 분자 진단 검사가 가장 널리 사용되고 검증된 기술이다. 분자 진단 분석법은 SARS-CoV-2에 감염된 것으로 의심되는 개인에서 바이러스 RNA를 직접 검출하기 위한 gold standard이다. 항체 기반 혈청 검사는 지역사회에서 COVID-19 유병률을 결정하고 면역력을 획득한 개인을 식별하는 데 사용되는 간접 검사이다. 본 논문에서는 시판되고 FDA가 승인한 분자 및 면역학적 진단 측정을 평가하여 성능 특성을 분석하였다.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.107-112
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• 2008

Diagnostic laryngeal electromyography (LEMG) relatively evaluates the electrophysiologic status of the larynx and provides critical clinical informations that no other tests can provide. However, LEMG is still not widely applied as a routine tool in clinical practice. One reason for this is the technical and interpretative difficulties of LEMG. But if LEMG is performed by a team approach consisting of an otolaryngologist and a neurologist, the technique and the interpretation of LEMG are not difficult to master. Another reason is that there is still not exact standard guideline for clinical application of LEMG. LEMG is an essential diagnostic test in evaluating patients with neuromuscular disorders, particulary vocal fold immobility, reduced mobility of vocal fold. The more we have used LEMG, the more we have found it useful in the evaluation and treatment of voice disorders, and the role of LEMG will be extended.

• 대한한방소아과학회지
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• 제15권1호
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• pp.165-182
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• 2001

In oriental medicine, diagnostic method was the four examination(四診) which was composed of inspection(望診), inquiring(問診), listening and smelling(聞診), palpation(切診). Inspection of skin color(望色) indicated the observation of patient's complexion(色診). In oriental medical theory, complexion of face was related to meridians(經絡) and zang-fu(贓腑). The change of complexion was reflected the ups and downs of qi(氣) and blood(血), the relative seriousness of an illness. especially, observation of complexion was essential in children, because of diagnostic difficulty and positive change according to each disease. The purpose of this study was to construct for standard measurement and invent for computerizing diagnostic system which was based on observation of complexion. It was objectively measured complexion using spectrophotometer and chroma meter. Measurement of complexion should make an offer the index of diagnosis.

• Tuberculosis and Respiratory Diseases
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• 제78권2호
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• pp.64-71
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• 2015

Pulmonary tuberculosis (TB) persists as a great public health problem in Korea. Increases in the overall age of the population and the rise of drug-resistant TB have reinforced the need for rapid diagnostic improvements and new modalities to detect TB and drug-resistant TB, as well as to improve TB control. Standard guidelines and recent advances for diagnosing pulmonary TB are summarized in this article. An early and accurate diagnosis of pulmonary TB should be established using chest X-ray, sputum microscopy, culture in both liquid and solid media, and nucleic acid amplification. Chest computed tomography, histopathological examination of biopsy samples, and new molecular diagnostic tests can be used for earlier and improved diagnoses, especially in patients with smear-negative pulmonary TB or clinically-diagnosed TB and drug-resistant TB.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1087-1094
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• 2020

Transrectal ultrasound (TRUS)-guided systematic biopsy, the current gold standard for the detection of prostate cancer, suffers from low sensitivity for clinically significant cancer. The use of diagnostic multiparametric MRI has increased the relevance of targeted biopsy techniques such as MRI-TRUS fusion biopsy and direct (in-bore) MRI-guided biopsy, which have higher detection rate for clinically significant cancer. Although primarily used in patients who remain at high clinical suspicion for prostate cancer despite a negative systematic biopsy, with the increasing use of upfront diagnostic MRI, these biopsies are expected to replace routine systematic biopsies. This pictorial essay aims to enhance our understanding of the concepts of these biopsy techniques so that they can be performed safely and provide maximum diagnostic yield.

• 대한한의학회지
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• 제21권3호
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• pp.9-19
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• 2000

Objective : We proposed fundamental rules of prospective Korean Standard Classification of Diseases(Oriental Medicine). Methods : We analysed Korean Standard Classification of Diseases(Oriental Medicine)(established in 1994) in comparison with ICD-10 and Chinese Standard Classification of Disease(Traditional Chinese Medicine). Secondly, we analysed the diagnostic structure of Modem oriental medicine. Results : Korean Standard Classification of Diseases has an inappropriate writing structure, logical errors of classification, confusion of symptoms, 'bing', and 'zheng', inappropriate comparison of disease designations in oriental medicine and western medicine, and the ommission of important items. Secondly, we demonstrate the relations of 'bing' and 'zheng' in modem oriental medicine and disease designations in oriental medicine and western medicine. Conclusions : We propose the separate classification of 'bing' and 'zheng', the qualification of designated names, the structure of 'bing' and 'zheng' system, and a different writing method.

• 센서학회지
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• 제16권6호
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• pp.413-418
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• 2007

Uroflowmetry is of great convenience to diagnose benign prostate hypertrophy common in aged men. The urinary flow rate is obtained by weight measurement using load cell, however, sensitive to impact noise. An alternative technique was recently proposed to measure hydraulic pressure instead of weight and demonstrated to introduce significantly reduced noise. In this paper, we described the measured diagnostic parameters between the weight and pressure measuring techniques in 10 normal men. The weight and pressure signals were simultaneously acquired during urination, converted into urine volumes, then differentiated to obtain flow rate signals, which showed very similar waveforms. Diagnostic parameters evaluated by pressure measuring technique were well correlated with the standard weight measuring technique (correlation coefficient > 0.99). Therefore, the new uroflowmetry based on hydraulic pressure measurement can provide accurate diagnostic parameters, which would be clinically valid.

• 대한핵의학회지
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• 제37권4호
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• pp.207-218
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• 2003

Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.