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A Comparative Study of the Oriental and the Occidental Medical Literature on the Etiologies & Treatments for Palmoplantar Hyperhidrosis (수족한(手足汗)의 원인(原因)과 치료법(治療法)에 대한 동(東).서의학적(西醫學的) 고찰(考察))

  • Ko, Young-Chul;Shin, Jo-Young
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.268-295
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    • 1997
  • Sweating is natural phenomenon necessary for the regulation of an individual's body-temperature. The secretion of sweat is mediated by a portion of our vegetative nervous system(the sympathetic nervous system). In some people, this system is working at a very high activity level, far higher than needed to keep a constant temperature. This condition is referred to as hyperhidrosis. Especially excessive sweating of the hands and the feet is palmoplantar hyperhidrosis or volar hyperhidrosis. This is by far the most distressing condition. It was founded that the first important cause of this was emotional factor. The hands are much more exposed in social and prefessional activities than any other part of our body. Many individuals with palmoplantar hyperhidrosis are limited in their choice of proffession, because unable to manipulate materials sensitive to humidity or reluctant to shake hands; some patients arrive to the point to avoid social contact. The occidental medical treatments for palmoplantar hyperhidrosis include application of topical agents(chemical antiperspirants such as aluminum chloride), iontophoresis(treatment with electrical current), or surgery(thoracic sympathectomy). It was reported that the most effective treatment was thoracic sympathectomy. So this study was started to find the easy and effective oriental medical treatments against the occidental medical treatments through the oriental medical literature. The occidental medical idea for palmoplantar hyperhidrosis is only limited in neurologic system, so surgery is the best treatment. But the oriental medical idea for palmoplantar hyperhidrosis is much wider, so the oriental medical causes and treatments for this are able to be veriety. And the oriental medical teatment is freely in treating the patients of palmoplantar hyperhidrosis, because entire idea including pulse, facial color, mental condition, constitution and other symptom exists in the oriental medicine. The results of a bibliographic study of causes and treatments for palmoplantar are as follows; 1. The main causes of pa1moplantar hyperhidrosis are heat in the stomach, damp-heat in the spleen and the stomach, insufficiency of the spleen-qi and the stomach-qi, deficiency of the spleen-yin and the stomach-yin, and the others are the stomach-cold syndrome, stasis of blood and dyspepsia in the stomach, disorder of the liver-qi, deficiency of the heart-yin and the kidney-yin, deficiency of the heart-yang and the kidney-yang, stagnated heat in the liver and the spleen, the lung channel-heat etc. 2. The main methods of medical treatments for palmoplantar hyperhidrosis are clearing out the stomach-heat, eliminating dampness and heat in the spleen and the stomach, invigorating the spleen-qi and the stomach-qi, reinforcing the spleen-yin and the stomach-yin, warming the stomach, relaxing the liver and alleviating of mental depression and tonifying the heart and the kidney etc. 3. The main prescriptions of palmoplantar hyperhidrosis are Taesihotang, Palmultang-kakam, Samyeongbaechusan, Chongbisan, Sasammaekmundongtang, the others are Leejungtang, Hwangkikonjungtang, Seungkitang, Boyumtang, Baekhotang, Chongsimyonjayum, Moyrosan, etc. 4. Local medicine for external use are liquid after boiling alum in water for about 1 or 2 hours, liquid after boiling alum and pueraria root in water and liquid after boiling stragalus root, pueraria root, ledebouriella root and schizonepeta in water, etc. 5. The methods of acupuncture therapy include invigorating Bokyru, Yumkuk and purgating Hapkouk, or invigorating Bokyru, Kihae and purgating Hapkouk, or steadying Hapkouk, Nokung.

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The Immunogenicity and Safety Study of 47 Passaged Oka Strain Live Attenuated Varicella Vaccine in Healthy Children (건강한 소아에서의 47계대 Oka주 수두약독화 생백신의 면역원성 및 안전성에 관한 연구)

  • Kang, Jin Han;Kim, Jong Hyun;Suh, Byung Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.257-264
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    • 1997
  • Purpose: We performed this study to find out short period humoral immunogenicity and safety of 47 passaged Oka strain live attenuated varicella vaccine(1,400PFU) in 12 months to 15 years aged healthy children. Methods: Ninety nine healthy chidren, who have no histories of varicella vaccination, recent chicken pox illness and contact, allergy to other vaccines and underlying severe diseases, were involved in this study from April 1997 to August 1997. 5ml blood were collected before vaccination and after vaccination from all vaccinees to measure varicella membrane antibody by FAMA, and varicella IgG antibody by EIA. And immediate reactions within 30 minutes after vaccination, local and systemic reactions within 3 days after vaccination and vaccine induced systemic illness during 6 weeks postvaccination period were observed in all vaccinees to identify side effects of study vaccine. Results: 1) 49 seronegative and 50 seropositive vaccinees were identified in both prevaccination serologic tests. 2) Serologic responses after vaccination measured by the FAMA in seronegative group showed that the mean GMT level revealed 64.0, and seroconversion rate was 97.9%. And serologic responses after vaccination measured by the FAMA in seropositive group showed that the mean GMT level(242.2) was markedly elevated comparing with the mean GMT level(9.2) of pre vaccination. 3) The results of EIA in seronegative group revealed that postvaccination mean GMT was 435.2(prevaccination GMT; 78.7), and 100% seroconversion rate. Also, the results of EIA in seropositve group showed that the mean GMT level(769.9) of postvaccination was almostly two fold hihger than the mean GMT level(419.7) of prevaccination. 4) Observed local reactions like injection sites redness, pain, hardness and itching sense were mild and disappeared within 3 days, also shorterm systemic reactions like irritability, lethargy, poor appetites and rash were not remarkable. And there were no remarkable side effects due to vaccine during study period in all vaccinees. Conclusion: We confirmed that 47 paasaged Oka strain live attenuated varicella vaccine has high shorterm humoral immunogenicity and safety. However, we need more detail and longterm humoral and cell mediated immunogenicity studies of this vaccine including clinical field trials.

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Climate-related Changes in Fruit Growth of 'Fuyu' Persimmon during the Harvest Season (수확기 동안의 기상 변화에 따른 '부유' 감의 과실 생장)

  • Choi, Seong-Tae;Park, Doo-Sang;Son, Ji-Young;Park, Yeo-Ok;Hong, Kwang-Pyo;Cho, Kwang-Sik
    • Horticultural Science & Technology
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    • v.31 no.1
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    • pp.32-37
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    • 2013
  • Relationships among climate changes, early frost, and fruit growth were studied during the final month to harvest of late-maturing 'Fuyu' persimmon (Diospyros kaki) to assess the changes in fruit characteristics during this critical period. The heavy frost on Nov. 16 defoliated more than 70% of the leaves, but with little damage on the fruits. However, all the leaves were defoliated by the heavy frost on Nov. 20, and all the fruits were cold-damaged by $-3.3^{\circ}C$ on Nov. 21. Fruit weight increased by 8-25 g per week from Oct. 25 (142 days after full bloom) to Nov. 15, reaching to 250 g, but it decreased by 3-4 g per week after the frost. Hunter a value of fruit skin gradually increased until the last harvest on Nov. 29 with a temporary halt in early Nov. when temperature was high, whereas fruit firmness rapidly decreased after the frost on Nov. 21. Fruit soluble solids were $15.7-16.1^{\circ}Brix$ for the final month. When some branches were covered with non-woven fabrics to avoid direct contact with frost, the fruits on the branches were not visually damaged by the low temperature although 40-60% of their leaves were defoliated on Nov. 16. However, low temperature on Nov. 20 and 21 defoliated all the leaves, causing cold damage on the fruits. There was a highly significant correlation between the fruit diameter and its weight ($R^2$ = 0.73-0.91). So, the regression equations could be used to estimate weight from diameter of the fruits sampled from the branches with the non-woven fabrics. The calculated fruit weight reached to a maximum of 240 g on Nov. 15. Daily increases in fruit weight were 1.1-2.5 g from Oct. 25 to 31, 1.9-3.5 g from Oct. 31 to Nov. 7, and 1.4-1.6 g from Nov. 7 to 12. However, fruit weight decreased by 0.3-1 g per day after the cold damage on Nov. 21. The results indicate that the most appropriate harvest time could be dependent on relationship of fruit growth to climate.

Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area (구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구)

  • Chae, Hyun-Seok;Wang, Yuan-Kun;Lee, Jung-Jin;Song, Kwang-Yeob;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.342-349
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    • 2019
  • Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

우리나라 농촌지역의 출산조절행태 및 출산조절행위의 결정요인 분석

  • Chung, Kyung-Hee;Han, Seung-Hyun;Bang, Sook
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.33-53
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    • 1988
  • This study aimed at developing a desirable family planning policy and strategy by examining the current status of family planning practice in rural Korea and by indentifying the crucial factors which affect fertility control behavior. For this purpose, an analytical study was conducted, using the survey data collected in July 1985, on an interview basis, on 1, 440 married women living in the Soyi, Wonnam and Maingdong townships of Eumseong County(in North Chungcheong Province). This study population has the typical characteristics of rural areas, and the results of the analysis can be summarized as follows: 1. In regard to the demographic characteristics of the study population : their average age at marriage was 23.7, they had an average of 2.6 children( 1.3 boys, 1.3 girls) :10% experienced the death of their child (ren) :14% had spontaneous abortion(s) :4% weathered stillbirth(s) :35% went through induced abortion (s) : and 5.5% were currently pregnant. The average of their ideal numbers of children was 2.2, while 44% felt that they must have a son. 2. Looking at the contact rate with medical & health institutions, over the past 1 year, the visit rate to health subcenters was 43.7%, while 26.9% visited the (county) health center :59.6% had been to private clinics : and 41.5% went to the Soonchunhyang - Eumsung hospital : thus showing a relatively high rate of accessibility. 3. The utilization rate of family planning services was 76.5%, with tubectomy being the most prominent method at 52.3%, while the informants were health workers in 54.2% of the acceptors. Of the 8.4% who discontinued the use of contraceptive methods, only 26% did so due to want for pregnancy, natural infertility (meno - pause), or other reasons, while the remaining 74% stopped usage on account of side effects, failure in the methods themselves, and inconvenience of use, thus pointing to a situation where the proper choice of family planning methods have not yet been made. It can be noted that there is a strong motivation for early birth stopping as 35.3% practice family planning even with only one child, of which 38.3% have had sterilization operations. According to results of a multiple regression analysis, among the variables affecting contraception usage the most significant variable was the number of sons. 4. 34.8% experienced induced abortions. It was shown as a result of multiple regression analysis that the number of children and attitudes toward induced abortions extensively affected their frequency of abortions conducted. 5. In the regard to the relation between family planning and induced abortions, 33.7% of the women used both, while 52.0% of them used only the former(family planning), with only 1.4 % utilizing solely the latter(abortion), and 12.9% totally abstaining from fertility regulation : again, the discriminant analysis indicated that the choice of family planning and/or induced abortion was determined by the number of children and attitudes toward induced abortion. In view of the above mentioned results, the following are some comments and suggestions concerning problems related to the current family planning policies, in Korea : 1. It is difficult to expect a further quantitative expansion in family planning program operations, as there has been an excessive supply of target-oriented sterilization operations on women. From a maternal and child health care point of view, it will be desirable to have a diversification of service points in the future where family planning methods may be properly chosen, so that choices of methods which suit the mothers' characteristics and tastes may be made by the individuals themselves by strengthening their quality of family planning information services. 2. Along with the strengthening of the qualitative improvement of family planning services policies must be implemented to effectively promote the moral (ethical) deterrents to induced abortions and to preference for sons. From a maternal care standpoint, the social permissive norm toward induced abortion must be modified, and the bias towards son must be analyzed as the women with more daughters have a lower rate of family planning acceptance. Such changes in attitudes, however, can not be hoped to be accomplished with ad hoc policies, but will only be possible when an enhancement of the women's status(within the society) is brought about in a long - term perspective.

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Relationship between Access to Lewd Internet Contents by Middle School Students and Their Awareness of Sex (중학생의 인터넷음란물 접속과 성 의식의 관계)

  • Lim, Jong-In;Choi, In-Sook
    • The Journal of Korean Society for School & Community Health Education
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    • v.4
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    • pp.117-139
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    • 2003
  • The purpose of this research lies in presenting logical viability for the measures that curtail access to lewd Internet contents by middle school students amidst the reality in which lewd contents are circulated freely through the Internet, a medium that the middle school students find most easy to access. In order to establish right form of awareness towards sex, this research identified the ways they access the lewd Internet contents, their reaction after the exposure to those contents, their knowledge of sex, their concerns regarding sex and their accessibility to sexual activities in order to conduct a comparative analysis on the relationship between lewd Internet contents and their awareness of sex. First, realities of accessing lewd Internet contents and reactions according to the demographics of middle school students There isa significant difference in the experience of accessing lewd Internet contents in terms of gender. Mostly, male students tend to access the contents more. As for the way they access the lewd Internet contents, both male and female students replied that they access through spam mail of lewd nature. Thus, measures to address this problem are needed urgently. As to when they first accessed the lewd contents, most of the research subjects replied that they accessed either in elementary school period or in the early middle school period. This shows that most of the students got exposed to lewd contents even before they could establish positive, correct awareness of sex. Thus, there is a risk that they may formulate wrong kind of sexual awareness. Accordingly, it is necessary to develop measures through focused sex education. Students are divided into two groups according to the time they spend on the contents averagely: those who spend over one hour and those who spend less than an hour on the lewd contents. If the students spending longer hours are not to be checked and properly guided, it may lead to increasing cases of sexual delinquencies due to their wrongly formed awareness of sex. When the question of existence(non-existence) of guardian was addressed, students with both parents tend to access the lewd Internet contents in a more diverse manner and tend to access more compared to those students from single parent or no-parent families. Accordingly, guardians need to pay attention to how their children are using the Internet. Second, awareness of sex depending on the middle school students' demographics In case of sexual knowledge, middle school students shows relatively high level of knowledge. In particular, female students are found more knowledgeable than male students, and the students in upper years are more knowledgeable as well. As a result, this research recommends that the students in lower years should be guided with more basc and detailed information, while those in upper years need to be taught to form and express their own thoughts and attitudes and to build up independence on this matter. In case of worries about sex, both male and female students don't worry too much about it. However, male students are more concerned about sex than female students in a more diverse ways. As for the differences by academic year, concerns for sex increase, as students get older. Accordingly, sex education that helps establish sound perception of the opposite sex and that focuses on the etiquettes that one must adhere to at the presence of the opposite sex need to be conducted against middle school students. In case of accessibility to sex, male students manifest higher tendency than female students. As for the differences by academic year, those in the first and second years show higher accessibility than those in their third year. In general, younger students tend to be more open-minded toward sex. Accordingly, students in lower academic years need to undergo basic knowledge oriented sex education, whereas those in upper academic years need to undergo discussion centered sex education where they subject to questions regarding their attitude and opinion. Third, relationship between the reactions after the exposure to the lewd Internet contents and their awareness of sex As the frequency of contact with lewd Internet contents increases, awareness of sex increases as well. Thus, the lewd Internet contents contribute to the increase in students' concern for sex as well as increase in accessibility to sex, which eventually become barriers to students' establishment of a healthy perception of sex. Reactions to sex after the exposure to lewd Internet contents and awareness of sex indicate a significant correlation. However, negative correlation is manifested with knowledge of sex. Thus, it is possible to know that the greater access to lewd Internet contents does not necessarily translate into increase in knowledge of sex. However, the study showed there is a correlation between concerns for sex and the level of accessibility to sex. In more detail, the more reactions to the contents they show, the more concerns for sex they have and the more positively they take acceptability to sex. Moreover, it is necessary to develop necessary measures since textbooks today do not include measures needed to address the lewd Internet contents. Given the above findings, it is necessary to continue to complement structural measures in order to prevent easy access of lewd Internet contents by middle school students. Moreover, it is necessary to be considerate of the students so that they themselves can form a healthy Internet culture and grow up within positive framework for the sex education.

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The Necessity of Introducing Development Fee for Archaeology and Suggestions (매장문화재부담금제도의 도입 필요성과 방안)

  • Kim, Gwon Gu
    • Korean Journal of Heritage: History & Science
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    • v.49 no.3
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    • pp.224-239
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    • 2016
  • This article aims to review the major problems of the present Korean management system of archaeology and to seek desirable suggestions in order to pursue the sustainable harmony between the recovery of academic excavations and economic development. In order to continue the sustainable harmony between preserving the values of archaeological resources as limited pure public goods and economic development, the present system of developer's payment for archaeology must be replaced by the introduction of the development fee for archaeology. The excavation of archaeological resources have been done according to the market principle, that is, the lower price principle. But the principle has produced a lot of serious problems in the Korean management system of archaeology, which must result in the market failure. So the governmental intervention is urgently required. By introducing the development fee, the archaeological field units and the developers can avoid direct contact. Instead, the Heritage Management Office will operate the excavation fund raised by the development fee for archaeology in order to avoid low-price contracts, degrading excavation quality, and other related residents' complaints and social conflicts in advance. In addition, the budget for purchasing the preserved excavation sites, which are the source of the landowners' enormous complaints, must be allocated to the Heritage Management Office by the Ministry of Planning and Finance. More budget for small-sized excavations must be allocated as well in order to solve many residents' complaints. These budget increase will be the fundamentals to decrease the residents' big complaints and social conflicts in relation with the archaeological management, which will be a challenge of the Korean government. Along with the governmental efforts, the archaeological field units must do their all-out efforts to overcome many problems in excavation including low-price contracts. Finally, the wage system and working status system must be revised. Excellent young excavators must be recruited appropriately and continue to work in a safe psychological condition, which are the basis to guarantee high-quality excavation.

Characterization of Dopamine Receptor D4 Gene Polymorphisms in Horses (말에서 Dopamine Receptor D4 유전자의 변이 특성 분석)

  • Choi, Jae-Young;Choi, Yeonju;Lee, Jongan;Shin, Sang-Min;Yoon, Minjung;Kang, Yong-Jun;Shin, Moon-Cheol;Yoo, Ji-Hyun;Kim, Hyeonah;Cho, In-Cheol;Yang, Byoung-Chul;Kim, Nam-Young
    • Journal of Life Science
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    • v.32 no.1
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    • pp.29-35
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    • 2022
  • This study was conducted to analyze the genetic polymorphisms of dopamine receptor D4 (DRD4) in horse breeds and its association with substrate characteristics in Jeju crossbreds (Jeju Horse × Thoroughbred). Polymorphisms in DRD4 are candidate genes associated with temperament in various mammals, including humans. Single nucleotide polymorphism (SNP) G292A in the exon 3 region of the horse DRD4 has a reported association with curiosity and vigilance in thoroughbreds. Sanger sequencing was used to identify polymorphisms of the mutations in DRD4 in three horse breeds. The SNP frequency in Jeju horses was significantly different from the frequency in other breeds. Character evaluation, conducted in the Jeju crossbreds and scored using a temperament test and contact test, revealed a high correlation between each test. Comparison of the polymorphism in the DRD4 of horses and the results of the character evaluation revealed lower scores for all temperaments in horses carrying allele A. Comparison of the SNP of G292A and blood dopamine levels in Jeju crossbreds showed 2.87 times higher levels for the GA type than for the GG type. This study identified an association between DRD4 polymorphism and various test methods for evaluating horse temperament and levels of neurotransmitters. Further research could validate the use of this gene as a genetic marker for character evaluation.

Development of tracer concentration analysis method using drone-based spatio-temporal hyperspectral image and RGB image (드론기반 시공간 초분광영상 및 RGB영상을 활용한 추적자 농도분석 기법 개발)

  • Gwon, Yeonghwa;Kim, Dongsu;You, Hojun;Han, Eunjin;Kwon, Siyoon;Kim, Youngdo
    • Journal of Korea Water Resources Association
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    • v.55 no.8
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    • pp.623-634
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    • 2022
  • Due to river maintenance projects such as the creation of hydrophilic areas around rivers and the Four Rivers Project, the flow characteristics of rivers are continuously changing, and the risk of water quality accidents due to the inflow of various pollutants is increasing. In the event of a water quality accident, it is necessary to minimize the effect on the downstream side by predicting the concentration and arrival time of pollutants in consideration of the flow characteristics of the river. In order to track the behavior of these pollutants, it is necessary to calculate the diffusion coefficient and dispersion coefficient for each section of the river. Among them, the dispersion coefficient is used to analyze the diffusion range of soluble pollutants. Existing experimental research cases for tracking the behavior of pollutants require a lot of manpower and cost, and it is difficult to obtain spatially high-resolution data due to limited equipment operation. Recently, research on tracking contaminants using RGB drones has been conducted, but RGB images also have a limitation in that spectral information is limitedly collected. In this study, to supplement the limitations of existing studies, a hyperspectral sensor was mounted on a remote sensing platform using a drone to collect temporally and spatially higher-resolution data than conventional contact measurement. Using the collected spatio-temporal hyperspectral images, the tracer concentration was calculated and the transverse dispersion coefficient was derived. It is expected that by overcoming the limitations of the drone platform through future research and upgrading the dispersion coefficient calculation technology, it will be possible to detect various pollutants leaking into the water system, and to detect changes in various water quality items and river factors.

A Study on IMRT (Intensity Modulated Radiation Therapy) Delivery Technique and FFF (Flattening Filter Free) Beam to Increase Skin Dose to Irregularly Shaped Skin Surface. (IMRT(Intensity Modulated Radiation Therapy)전달 기법과 FFF(Flattening Filter Free) 빔을 이용한 요철 부위 피부 선량 증가 방법에 대한 고찰)

  • Woo Heon;Son Sang Jun;Je Young Wan
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.7-12
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    • 2022
  • Purpose: When it is difficult to secure the skin dose when treating Irregularly Shaped Skin Surface such as the nose where it is difficult to apply a bolus, increase the skin dose with a treatment plan that combines the IMRT (Intensity Modulated Radiation Therapy) delivery technique and FFF (Flattening Filter Free), It was tried to find out whether or not through the phantom experiment. Materials & Methods: Based on the 6MV-FF (Flattening Filter) and VMAT (Volumetric-Modulated Arc Therapy) treatment plans, which are the most commonly used treatment plans for head and neck cancer, A comparison group was created by combining VMAT and IMRT, FF and FFF, and the presence or absence of 5 mm bolus application. A virtual target was created on the Rando Phantom's nose, and a virtual bolus of 5 mm was applied assuming full contact on the Rando Phantom's nose. Five measurement points were determined based on the phantom's nose, and the absorbed dose was measured by irradiating each treatment plan 3 times per treatment plan according to the treatment technique and whether or not the bolus was applied. Result: The difference in skin dose in FF vs FFF increased in the case of FFF in VMAT bolus off, and there was no difference in case of IMRT bolus off. In VMAT bolus 5 mm and IMRT bolus 5 mm, it was confirmed that the skin dose was rather decreased in FFF. The difference in skin dose between VMAT and IMRT increased only in the case of FFF bolus off, and there was no statistical difference in the rest. For the difference in skin dose between bolus off vs bolus 5 mm, it was confirmed that the skin dose increased at bolus 5 mm, except for the case of using IMRT FFF. The treatment plan combining IMRT and FFF did not find any statistically significant difference as a result of analyzing the measured values of the treatment plan skin dose applied with a 5 mm bolus using the commonly used VMAT and FF. Therefore, it is thought that by using IMRT_FFF, it is possible to deliver a skin dose similar to that of applying a 5 mm bolus to VMAT_FF, which can be useful for patients who need a high skin dose but have difficulty applying a bolus. Conclusion: For patients who find it difficult to apply bolus, an increase in skin dose can be expected with a treatment plan that properly combines IMRT and FFF compared to VMAT and FF.