• Progress in Medical Physics
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• v.8 no.1
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• pp.25-29
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• 1997

Ir-192 source activity for high dose rate brachytherapy is measured using Farmertype ionization chamber. The source-to-chamber distance is 10 cm and the measured charge unit is converted to activity unit. The measured values are compared to the values provided from vendor. Because of time dependency of Ir-192 source activity, the activities are regularly checked and compared to calculated values. As the accuracy of Ir-192 source activity is depend on the mechanical measurement setup, we estimated the precision of remote controlled source dwell position using home-made device and film scanner. The difference between measured and predicted dwell position is within 1 mm. As a result, the errors of source activity are 0.7${\pm}$1.5 ％ for measured and vendor-provided values and 0.l${\pm}$1.2％ for measured and time-dependent calculated vlaues. In conclusion, our measured activity has been comparable to the values provided from vendor and our brachytherapy unit has been very accurate until now. Regular quality control of brachytherapy is essential for successful treatment which depends on the accuracy of source position and activity.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.523-534
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• 2010

Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.

• Journal of Korean society of Dental Hygiene
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• v.9 no.1
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• pp.169-180
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• 2009

This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.568-583
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• 1994

In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.2
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• pp.179-186
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• 2001

The purpose of this study is to develop a systematic and efficient curriculum for the rehabilitation nurse specialist program. This research was carried out as a group work of 15 experts in order to share various opinions about the curriculum, and also through literature review. Articles, curriculums of other Clinical Nurse Specialist Programs, medical laws guidelines, as well as Clinical Nurse Specialist Program from the Korean Nurses Association were reviewed, and the issue was discussed throughly via group meetings. The developed curriculum is as follows: 1. Educational philosophy lies in the fact that the rehabilitation nurses support the patients to maximize their potential and functional level, so that they could maintain healthy state and re-adapt to changed environment. Furthermore the rehabilitation nurses are disposed of arbitrary decision power under their own responsibility, thus they take charge of welfare and healthy environment of the local society through the patients(subjects) and local resources. 2. Educational goals are to train rehabilitation nurse specialist, who correspond to the social needs, so to say, those who have the knowledge and skills for nursing practice, education and research. 3. The curriculum consists of 37 credits, of which 24 credits are based on lectures and 13 credits based on clinical practice. General courses are 3 subjects (5 credits) ; nursing theory, nursing research, and laws/ethics. Mandatry courses are 8 subjects with 19 credits; advanced physical assessment, pharmacology, pathophysiology, issues in rehabilitation nursing, advanced rehabilitation nursing intervention I, advanced rehabilitation nursing intervention II, sports physiology, special rehabilitation nursing intervention. As for the clinical practice courses, assessment and evaluation for rehabilitation(64 hours), community and home based rehabilitation nursing(128 hours), hospital based rehabilitation nursing(128 hours), institution based rehabilitation nursing(96 hours) would be treated. 4. Contents of the curses were developed to correspond with the courses' objectives and specific items. 5. Evaluation would be carried out both in the lecture and in the clinical practice. The knowledge and skills of the students would be measured to ensure full validity and credibility. However this developed curriculum should be continuously modified and updated in more desirable direction.

• Progress in Medical Physics
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• v.13 no.2
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• pp.55-61
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• 2002

In this work, EPM (effective point of measurement) of parallel plate ionization chamber with three different spacing were investigated. If the plate separation is less than 2 mm one generally assumes that the effective point of measurement is just behind the front window of the parallel plate ionization chamber. For chamber with relatively large separation, such as the ones used for very accurate exposure measurements, this assumption breaks down and the EPM depends on plate separation and thickness of the front window. For parallel plate chambers, conventional theoretical analyses suggest that the EPM is the inner front wall and that it shifts towards the geometric centre of the chamber as the plate separation increases. The PP-IC (parallel plate ionization chamber) is fabricated using acrylic plate for the chamber medium and printed circuit board for electrical configuration. The various sizes of the sensitive volumes designed so far are 0.9, 1.9, and 3.1 cc. The gap between two electrodes ranges from 3, 6, and 10mm. Also the charge-to-voltage converter is designed to collect the electrons produced in the ionization chamber cavity. As the result of our experiment, the EPM shift was within 0.6 mm in photon beams and 0.4 mm to 2.5 mm in electron beams for the plate separation of 6 mm and 10 mm. EPM shifts towards the geometric center of the chamber as the plate separation increases.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.309-314
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• 2012

Nowadays, digital Radiography (DR) systems are widely used in clinical sites and substitute the analog-film x-ray imaging systems. The resolution of DR images depends on several factors such as characteristic contrast and motion of the object, the focal spot size and the quality of x-ray beam, x-ray scattering, the performance of the DR detector (x-ray conversion efficiency, the intrinsic resolution). The DR detector is composed of an x-ray capturing element, a coupling element and a collecting element, which systematically affect the system resolution. Generally speaking, the resolution of a medical imaging system is the discrimination ability of anatomical structures. Modulation transfer function (MTF) is widely used for the quantification of the resolution performance for an imaging system. MTF is defined as the frequency response of the imaging system to the input of a point spread function and can be obtained by doing Fourier transform of a line spread function, which is extracted from a test image. In clinic, radiologic technologists, who are in charge of system maintenance and quality control, have to evaluate or make routine check on their imaging system. However, it is not an easy task for the radiologic technologists to measure MTF accurately due to lack of their engineering and mathematical backgrounds. The objective of this study is to develop and provide for radiologic technologists a medical system imaging evaluation tool, so that they can measure and quantify system performance easily.

• Journal of the Korean Dietetic Association
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• v.19 no.1
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• pp.69-81
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• 2013

The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.807-812
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• 2009

The late Professor Lee CB (1915~1967) was one of the pioneers in the early stages of thoracic surgery in Korea while he was in charge of the Department of Thoracic and Cardiovascular Surgery at Seoul National University hospital as the first director from 1957 until he died of liver cancer in 1967. He was a graduate from the old Seoul National University, and he dedicated himself to the field of lung surgery after he joined the army during the Korean War, which broke out in 1950. Among his many contributions to pulmonary surgery, he performed the first partial lung resection in Korea in 1953. His lecture notes were recently found. These lecture notes for medical students were written by hand in late 1950s, Considering the content and form of the lecture notes, they are thought to have very significant historical value. The lecture notes were a total of 277 pages on general thoracic surgery and cardiovascular surgery with 75 self-drawn figures. This study was intended to facilitate a better understanding of the history of thoracic surgery in Korea, and especially for young thoracic surgeons. These notes may well contribute to the field of Thoracic and Cardiovascular Surgery in Korea.