• Title/Summary/Keyword: Korean Medicine Doctor

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Post-examination Management State of Dental Caries in Elementary School Students in Conjunction with a Mother's Dental Health Beliefs (초등학교 치아우식 아동의 구강검진 후 관리 실태와 어머니의 구강건강신념과의 관계)

  • Bae, Jin-Soon;Chang, Seong-Sil
    • Journal of the Korean Society of School Health
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    • v.12 no.2
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    • pp.305-319
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    • 1999
  • The objective of this study were to evaluate the relation between post-examination management states of dental caries in elementary school students and a mother's dental health beliefs. We systematically chose 10 elementary school in urban and rural areas of Chungnam Province and determined the first class students of 5 and 6 grade in each school as study subjects. Among 837 participants, 669 students were diagnosed with dental caries after a 1998 periodic dental health examination was answered completely and analysed. The contents of the questionnaire for students were general characteristics, dental health behaviors, notification factors, treatment factors. Their mothers were surveyed by another questionnaire. The contents of the questionnaire for mothers were also general characteristics, dental health behaviors, and dental health beliefs. The result of this study were as follows 1. The prevalence of dental caries was 65.0% and there was no significant difference between urban and rural areas. 2. Meanwhile, 63.8% of students in urban areas knew the examination result through a doctor's explanation, 52.4% of students in rural areas learned through a school notification letter, 82.9% of all the students let their parents know of their dental caries. 3. Among the dental caries group, 36.3% of the students were treated as for treatment, most students in urban areas visited a dental clinic, but those in rural areas visited the dental dept of a public health center as for the treatment time, 35.9% of the students were treated immediately after the examination. 4. 44.9% of those treated answered that they felt they needed treatment; 67.2% of those not treated answered that they considered the treatment as a bother and unnecessary due to no pain. 5. Overall, the scores in the dental health beliefs in mothers were low. Especially among the 5 items of susceptibility and seriousness, the scored were very low but the benefit was high. Logistic regression analysis showed that the treatment of a child's dental caries was significantly associated with low scores of benefit in those untreated and high scores among those treated. Considering these results, health education to stimalate a mother's susceptibility and seriousness in health beliefs and for students to learn the need for treatment, including a more detailed post exam management system at the school level should be considered for a higher treatment rate.

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Usefulness Evaluation of HRCT using Reconstruction in Chest CT (흉부CT 검사 시 HRCT 영상 재구성의 유용성)

  • Park, Sung-Min;Kim, Keung-Sik;Kang, Seong-Min;Yoo, Beong-Gyu;Lee, Ki-Bae
    • Korean Journal of Digital Imaging in Medicine
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    • v.17 no.1
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    • pp.13-18
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    • 2015
  • Purpose : Skip the repetitive HRCT axial scan in order to reduce the exposure of patients during chest HRCT scan, Helical Scan Data into a reconstructed image, and exposure of the patient change and visually evaluate the usefulness of the HRCT images. Materials and method : Patients were enrolled in the survey are 50 people who underwent chest CT scans of patients who presented to the hospital from January 2015 to March 2015. 50 people surveyed 22 people men and 28 people women people showed an average distribution of 30 to 80 years age was 48 years. 50 patients to Somatom Sensation 64 ch (Siemens) model with 120 kVp tube voltage to a reference mAs tube current to mAs (Care dose, Siemens) as a whole, including the lungs and the chest CT scan was performed. Scan upon each patient CARE dose 4D (Automatic exposure control, Siemens Medical Solution Erlangen, Germany) was to maintain the proper radiation dose scan every cross-section through a device that automatically adjusts the tube current of. CT scan is the rotation time of the Tube slice collimation, slice width 0.6 mm, pitch factor was made under the terms of 1.4. CT scan obtained after the raw data (raw data) to the upper surface of the axial images and coronal images for each slice thickness 1 mm, 5 mm intervals in the high spatial frequency calculation method (hight spatial resolution algorithm, B60 sharp) was the use of the lung window center -500 HU, windows were reconstructed into images in the interval -1000 HU to see. Result : 1. Measure the total value of DLP 50 patients who proceed to chest CT group A (Helical Scan after scan performed with HRCT) and group B (Helical Scan after the HR image reconstruction to the original data) compared with the group divided, analysis As a result of the age, but show little difference for each age group it had a decreased average dose of about 9%. 2. A Radiation read the results of the two Radiologist and a doctor upper lobe and middle lobe of the lung takes effect the visual evaluation is not a big difference between the two images both, depending on the age of the patient, especially if the blood vessels of the lower lobe (A: 3.4, B: 4.6) and bronchi(A: 3.8, B4.7) image shake caused by breathing in anxiety (blurring lead) to the original data (raw data) showed that the reconstructed image is been more useful in diagnostic terms. Conclusion : Scan was confirmed a continuous, rapid motion video to get Helical scan is much lower lobe lung reduction in visual blurring, Helical scan data to not repeat the examination by obtaining HRCT images reorganization reduced the exposure of the patient.

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Study on image quality improvement using Non-Linear Look-Up Table (비선형 Look-Up Table을 통한 영상 화질 개선에 관한 연구)

  • Kim, Sun-Chil;Lee, Jun-Il
    • Korean Journal of Digital Imaging in Medicine
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    • v.5 no.1
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    • pp.32-44
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    • 2002
  • The role of radiology department has been greatly increased in the past few years as the technology in the medical imaging devices improved and the introduction of PACS (Picture Archiving and Communications System) to the conventional film-based diagnostic structure is a truly remarkable factor to the medical history. In addition, the value of using digital information in medical imaging is highly expected to grow as the technology over the computer and the network improves. However, the current medical practice, using PACS is somewhat limited compared to the film-based conventional one due to a poor image quality. The image quality is the most important and inevitable factor in the PACS environment and it is one of the most necessary steps to more wide practice of digital imaging. The existing image quality control tools are limited in controlling images produced from the medical modalities, because they cannot display the real image changing status. Thus, the image quality is distorted and the ability to diagnosis becomes hindered compared to the one of the film-based practice. In addition, the workflow of the radiologist greatly increases; as every doctor has to perform his or her own image quality control every time they view images produced from the medical modalities. To resolve these kinds of problems and enhance current medical practice under the PACS environment, we have developed a program to display a better image quality by using the ROI optical density of the existing gray level values. When the LUT is used properly, small detailed regions, which cannot be seen by using the existing image quality controls are easily displayed and thus, greatly improves digital medical practice. The purpose of this study is to provide an easier medical practice to physicians, by applying the technology of converting the H-D curves of the analog film screen to the digital imaging technology and to preset image quality control values to each exposed body part, modality and group of physicians for a better and easier medical practice. We have asked to 5 well known professional physicians to compare image quality of the same set of exam by using the two different methods: existing image quality control and the LUT technology. As the result, the LUT technology was enormously favored over the existing image quality control method. All the physicians have pointed out the far more superiority of the LUT over the existing image quality control method and highly praised its ability to display small detailed regions, which cannot be displayed by existing image quality control tools. Two physicians expressed the necessity of presetting the LUT values for each exposed body part. Overall, the LUT technology yielded a great interest among the physicians and highly praised for its ability to overcome currently embedded problems of PACS. We strongly believe that the LUT technology can enhance the current medical practice and open a new beginning in the future medical imaging.

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A Criminal Legal Study in the Protecting the Right of Surgical Patients - Self-Determination of Patients - (수술환자의 권리보호에 대한 형사법적 쟁점 - 환자의 자기결정권을 중심으로 -)

  • Yoo, Jae Geun
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.3-26
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    • 2015
  • Recently, Practicing of ghost surgery and duty of informed consent of doctors have become a big issue in the medical dispute and lawsuits. The ground of admitting the informed consent and the agreement(self-determination of patients) can be based on the dignity of man and the right to pursue his happiness guaranteed under Article 10 of the constitution in theory. However there are no explicit legal regulations on the duty of the informed consent and there is no substantive legal enactment on the informed consent, but there is a collision between self-determination of patients and the discretionary power of doctors. If the discretionary power on the duty of the informed consent was extended it may result in the infringement of the right of surgical patients, so called arbitrary medical treatment. Relating to this issue, New Jersey Supreme Court held that a patient has the right to determine not only whether surgery is to be performed on him, but also who shall perform it. Moreover it held that a surgeon who operates without the patient's consent engages in the unauthorized touching of another and, thus, commits a battery'. But there are no ghost surgery cases adopting battery theory in Korea, and professional negligence has been considered rather than the battery, regarding an absence of hostile intent to injure patient. Supreme Court of Korea held that a doctor who operates a medical procedure without the patient's valid prior consent based on wrong diagnosis commits professional negligence resulting in injury, and the patient's invalid consent do not preclude wrongfulness'. However, if a health care provider conducts a completely non-consensual treatment or substitute surgeon without consent, the action should be plead in battery, not negligence, but if a health care provider violate his duty of care in obtaining the consent of the patient by failing to disclosure all relevant information (risks) that a reasonable person would deem significant in making a decision to have the procedure, the action should be plead in negligence, not battery. Therefore, the scope of patients' self-determination can be protected by stating clearly the scope of the duty of the informed consent and the exemption of the informed consent legislatively, it is considered that it is valid to legislate the limitation of the discretionary power.

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Analysis Study on the Detection and Classification of COVID-19 in Chest X-ray Images using Artificial Intelligence (인공지능을 활용한 흉부 엑스선 영상의 코로나19 검출 및 분류에 대한 분석 연구)

  • Yoon, Myeong-Seong;Kwon, Chae-Rim;Kim, Sung-Min;Kim, Su-In;Jo, Sung-Jun;Choi, Yu-Chan;Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.661-672
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    • 2022
  • After the outbreak of the SARS-CoV2 virus that causes COVID-19, it spreads around the world with the number of infections and deaths rising rapidly caused a shortage of medical resources. As a way to solve this problem, chest X-ray diagnosis using Artificial Intelligence(AI) received attention as a primary diagnostic method. The purpose of this study is to comprehensively analyze the detection of COVID-19 via AI. To achieve this purpose, 292 studies were collected through a series of Classification methods. Based on these data, performance measurement information including Accuracy, Precision, Area Under Cover(AUC), Sensitivity, Specificity, F1-score, Recall, K-fold, Architecture and Class were analyzed. As a result, the average Accuracy, Precision, AUC, Sensitivity and Specificity were achieved as 95.2%, 94.81%, 94.01%, 93.5%, and 93.92%, respectively. Although the performance measurement information on a year-on-year basis gradually increased, furthermore, we conducted a study on the rate of change according to the number of Class and image data, the ratio of use of Architecture and about the K-fold. Currently, diagnosis of COVID-19 using AI has several problems to be used independently, however, it is expected that it will be sufficient to be used as a doctor's assistant.

A Study on Aid in Dying (조력사망(Aid in Dying)에 대한 고찰)

  • Lee, Jieun
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.67-96
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    • 2022
  • "Aid in Dying" means that when a decision-making patient suffers from an incurable disease, a drug that can speed up death is prescribed by a doctor and used to lead to death. Since the suspension of life-sustaining treatment was institutionalized based on human dignity and patient autonomy, the question of whether assisted death can be legally justified in relation to the right to receive medical help to shorten one's life to die with dignity has recently been actively discussed. In Korea, since the suspension of life-sustaining treatment was institutionalized by the enactment of the Life-sustaining Treatment Decision Act in 2016, an amendment to the Life-sustaining Treatment Act was recently proposed to legalize Aid in Dying. The global trend is that human "Right to Die" is discussed in the division of life and death, from the suspension of life-sustaining treatment to assisted death, and again in the order of euthanasia. In this paper, we started discussing dignified death and institutionalized patients' right to self-determination, looked at the controversy in the United States, which legislated assisted death in many states since the 2000s, and analyzed the main contents of California's End of Life Option Act and the data after enforcement. The strict requirements for Aid in Dying, such as voluntary confirmation of patients' intentions and doctors' obligation to provide information, and the results of California's Aid in dying system, composed of relatively diverse races, were reviewed.

Non Face-to-Face Treatment and Not-informed Medication to Persons with Mental Disorders (정신질환자에 대한 비대면진료 및 비고지투약 -치료적 대화의 복원을 위한 모색적 고찰-)

  • Jung, Sangmin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.149-192
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    • 2024
  • People with mental illness are generally either unaware of their illness or unwilling to voluntarily seek treatment, which makes treatment difficult and the pain mainly passed on to their families. Accordingly, non-face-to-face treatment, in which the patient is diagnosed by interviews with the family and unannounced medication, in which medication is secretly administered through the family, can be performed, and this has been considered a necessary evil. Even considering realistic aspects such as the special nature of mental health care and families' suffer, not-informed treatment without consent violates not only medical laws, but also human rights of mentally ill patients. Above all, if the patient finds out about this late, the trust between the patient, family, and doctor is completely broken, and a treatment is absolutely refused. Japan's Chiba decision, which presents exceptional conditions for allowance might be a solution. However, it would not be a right solution, considering that it could lead to long-term unannounced medication and completely cut off treatment through therapeutic dialogue. Ultimately, it need to approach this problem and seek alternatives through restoration of therapeutic dialogue.

Comparative Volume Measuring Methods According to the Tumor Characters in PET/CT (PET/CT 검사에서 종양의 특성에 따른 체적 측정 방법 비교)

  • Choi, Yong Hoon;Ban, Yung Gak;Oh, Shin Hyun;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.52-58
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    • 2016
  • Purpose Recent retrospective studies are being actively conducted to analyze the survival of patients with SUVmax, MTV, TLG, such as information from a variety of PET originating. However, there is no clear way is difficult to accurately measure the volume of the tumor may be the difference between the caster is raised. In this study, to evaluate compare the volume measuring methods according to the characteristics of the tumor. Materials and Methods 18F-saline to fill the NEMA IEC Body Phantom insert the volume of balance and imbalance in phantom were acquired to the Biograph truepoint 40 (Siemens medical system, Germany) PET/CT scanner. The ratio of the volume and Background was acquired as 3.0, 5.0, 8.0, 18, 40. Clinical patients were randomly selected 120 people in staging patients with cancer of the digestive system from the year 2010 until the year 2014. Measurement methods were used a 40% threshold, 50% threshold and gradient segmentation technique, i.e. PET EDGE. Five years of experience of the two radio-technologist and one doctor was measured by repeated three times. Analysis methods were Intraclass correlation coefficient and Pearson correlation. Results In Phantoms, the 40% threshold method gave the best concordance between measured and actual volumes (r = 0.992, 0.997). In clinical patient outcome agreement between observers EDGE it is as high as 0.999 (CI: 0.998-0.999). And there were no statistical significance of the difference between the measurements (P = 0.620). 40% threshold method showed the best correlation between the measurements (r = 0.953). Increasing the ratio of tumor to background decreased the influence of a measuring method. Conclusion How to measure volume of the tumor in the patient was clinically most useful is 50% and the lowest impact on the characteristics of the tumor. Therefore, to reduce the background of the patients in PET/CT scan, it should be required research and effort.

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Operation Efficiency Estimation of PET/CT Center by Work Form and Exposure Dose (근무형태 및 피폭선량에 따른 PET/CT실의 운영 효율성 평가)

  • Kweon, Oh-Jin;Jung, Su-Hee;Baek, Seung-Chan;Kim, Kyeong-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.93-97
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    • 2009
  • Purpose: Recognize circulation work system and fixing work system's merits and demerits that is enforced in operation of PET/CT center in sudden increase recently. Wish to estimate connectivity degree of individual exposure dose and PET/CT working that is managed periodically through this and look for operation efficiency of PET/CT center. Materials and Methods: (1) Find interrelationship of length of service to be individual exposure dose and PET/CT through TLD interpretation. Specially, evaluate on the basis of data of 2.5 years until 2 quarters 2006~2008 year that show patient increase rapidly the latest. (2) Recognize what countermeasure is evaluating problems happened at circulation work system and fixing work system. Results: Patient examination's number was 14,674 items until 2 quarters 2006~2008 year, and the $^{18}F$-FDG average injection amount was 461.5 MBq. 2 people of 10 radiotechnologist did fixing work PET area and GAMMA area each, and 8 people did circulation work of 3 times for 2.5 years. Average exposure dose that PET area and Gamma area's circulation men in service receive was 1.32 mSv, and PET area men in services came out average 0.825 mSv high than Gamma area men in services. Nurse's exposure dose is 0.28 mSv, and next 2 reason is conjectured. One is contact with patient that medicate $^{18}F$-FDG injection, and another is consultation about patient's next time schedule after examination end. Although exposure dose's amount is not much, is expected to consider continuation work possibility by exposure dose in case is a nurse with pregnancy possibility. Also, $^{131}I$-isotope therapy area's radiotechnologist that use capsule appeared by 0.12 mSv and a nuclear medicine doctor appeared by exposure dose that is less of 0.11 mSv. Conclusions: In case do PET/CT center circulation work after a long time, connoted danger that most men in service is consecutiveness deficiency of business and individual exposure dose increase at early 1 month. Specially, way for individual exposure dose's decrease should be considered. Also, need to evaluate abhorrent work form for efficient work system introduction, and enforce circulation and fixing work suggestion suitable shift working. Finally, must make normalized business guide and so on to prevent circulation work people's business efficiency decline.

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A study on the xylographica of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ ("의방류취(醫方類聚)"에 대한 판본(版本) 연구)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.1-15
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    • 1997
  • ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$(1445) is a book compiled the medical achievements of China and Choseon in those times and it's our source of pride to have it In this country. It also deserves careful investigation since this book can provide some clues of features of missing books in China and Korea. The extent of accuracy of xylographica of old books determines the possiblity of in depth further study. So authors attempted to investigate the xylographica of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ one of the 3 main books in Korea. Previous investigation done by Miki Sakae and Kim Doo Jong are noticeable. On the basis of their respective works, we analyzed 'Annals of the Choseon Dynasty' to find records related with ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ and estimated the situation of its publication. We tried figure the situation of those times of China, Japan and Korea(including North Korea) and tried to estimate the book's original xylographica as much as we could. By King Sejong's command, the first draft of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ consisted of 365 books was made by collaboration of civil officials and medical officers during the period from 1443 to 1445. And then from 1451(first year of Moonjong's reign) to 1464(l0th year of Sejo's reign) lots of manpowers were employed and through the process of countless erasure, proofreading, arrangement and rearrangement revised version of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ which is called by Sejo text was completed. After 3 years of wood engraving work, the first printed form of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ (alternately called Seongjong text) in folding case consisted of 266 chapters, 264 volumes came into the world in 1477.(8th year of Seongjong's reign). This was 32 years after the initial completion of the edition. So ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ exists in three forms as Sejong text, Sejo text and Seongjong text respectively. Since those texts were plundered during the Japanese invasion of Korea in 1592, none of the original copy remains within korea. The texts were constantly moved to kadeungcheongieong, to Kongdeungpyeongio, Jesookoan of Edo, to East University of department of classic books, to Cheoncho archives, to the Imperial Museum and finally is kept in the royal palace at present. (Doseoryo text Eulhae printing type) Reduced-size republication books of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ in wooden type were imported at the time of 'Byeongja Korea-Japan Treaty in 1876' and of those 2 books, one copy was treasured in the Royal Household of the Yi Dynasty and than was lost during the Korean War circa 1950. The other remaining copy has been kept succesively by Kojong's imperial grant, Royal doctor Hong Cheol Bo, Hong Taek Joo, Hong Ik Pyo the book agent, and now is kept In Yonsei University Library and this is the only existing copy in Korea at present. In 1965, Dongyang Medical college published the transcription version of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ consisting of 11 books and then in 1981 after edition and arrangement by Choonghoa(中華) publishing company, photoprint copy of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ was published in Keumgang(金剛) publishing company In 1991, October Yeokang(驛江) publishing company producd photocopies of ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ which were previously translated into Korean by North Korea Institute of Oriental Medicine and then issued by medical publishing company. In China, two institutes, Zhejiang Institute of Traditional Chinese Medicine and Huzhou Traditional Chinese Medical Hospital cooperated to publish a revised and marked text consiting of 11 books by adding marking points to japanse Edohakhoondang text which were used as a reference. Both the korean and chinese texts issued were grounded by the ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ kept in the royal palace. Any further study concerning ${\ulcorner}$Classified Collection of Medical Prescriptions${\lrcorner}$ can acquire its accuracy and objectivity when the japanese text kept in the royal palace is taken as an original copy.

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