• Journal of Radiation Protection and Research
• /
• 제39권3호
• /
• pp.150-158
• /
• 2014

각 의료기관 내 방사선 관련 종사자나 방사선 치료환자들은 진단 및 치료 시 필연적으로 의료상 피폭을 수반하게 된다. 국제방사선방호위원회(ICRP) 권고나 국제원자력기구(IAEA)의 기준에 따라 기준선량 제약치를 적용 및 권고 받고 있지만 1차 피폭대상자인 종사자나 환자들의 피폭최적관리를 위해서는 잠재적인 피폭대상자들에게 기존의 피폭관리 시스템보다 직접적이고 가용성이 높은 측정 및 분석 방법이 필요하다. 따라서 본 연구에서는 기존에 구비된 휴대용 단말과 연동하여 원거리에서 실시간으로 방사선 모니터링이 가능한 시스템을 개발하였다. 모니터링 시스템은 검출부, 영상부, 통신부 세 부분으로 구성되었다. 검출부는 시스템의 소형화를 위해 실리콘 광증배소자(silicon photomultiplier) 기반 섬광검출기를 설계하였으며, 영상부는 무선 CCD (charge-coupled device)카메라 모듈을 사용하여 검출부와 함께 Bluetooth 통신모듈을 통해 휴대용 단말로 측정된 방사선 정보와 영상이 전송된다. 제작된 시스템은 성능 평가를 위해 진단용 X-ray 발생장치와 $^{137}Cs$, $^{22}Na$, $^{60}Co$, $^{204}Tl$, $^{90}Sr$ 선원을 사용하였다. 측정결과를 통해 개발된 시스템은 gamma, beta, X-ray에 대해서 검출 반응성을 확인하였고, 방사선 세기에 따른 응답 선형성과 MCNPX 전산코드를 이용한 측정 거리에 따른 시스템의 검출 정확도 평가 시 3% 내외의 오차범위를 확인하였다. 본 연구의 결과는 방사선 검출 시스템 구성의 비용절감 효과와 개인피폭정도관리에 기여할 것으로 기대한다.

• 한국산학기술학회논문지
• /
• 제19권7호
• /
• pp.245-251
• /
• 2018

본 조사 연구는 일개 도내의 자동심장충격기 의무설치 기관의 자동심장충격기 설치현황 및 관리 점검 실태를 파악하기 위한 조사연구이다. 2017년 11월 20일부터 2017년 12월 20일까지 진행되었으며 총 169대의 자동심장충격기를 대상으로 조사하였다. 수집된 자료의 분석은 SPSS/WIN 20.0 프로그램을 이용하여 빈도분석과 백분율로 파악하였다. AED는 168대(99.41%)가 기관 실내에 설치되어 있는 것으로 조사되었으며, 24시간 항시 자동심장충격기가 운영되고 있는 경우는 47대(27.80%), 기관 운영시간 외에 자동심장충격기를 사용할 수 있는 경우는 44대(26.00%)으로 파악되었다. 책임관리자가 구조 및 응급처치 교육을 받은 경우가 87명(51.43%)이었으며, 자동심장충격기의 관리현황은 배터리 충전상태의 문제가 있는 경우는 2대(1.20%), 환자 부착용 AED패드의 유효기간이 지난 경우로 7대(4.10%)로 조사되었다. 향후 자동심장충격기 관리책임자를 위한 관리체계를 마련하고, 체계적 유지관리에 대한 정기적인 교육 프로그램을 개발하여 적용해야 한다. 또한 자동심장충격기 설치 관리에 대한 법률 강화 및 제도적 정비를 통한 지속적인 관리실태의 필요성에 대한 인식을 제고할 필요가 있다.

• 전기전자학회논문지
• /
• 제22권2호
• /
• pp.495-498
• /
• 2018

본 논문에서는 의료 및 산업용 X-선 발생장치의 선량평가를 위한 면적선량계(DAP)의 시스템을 제안한다. 제안하는 시스템은 Ion-Chamber를 이용한 면적선량 측정기술을 기반으로 진단용 X-선 장치에 의해 발생된 피폭선량을 명확히 측정할 수 있다. 면적선량계의 하드웨어부는 공기 중에서 X-선에 의해 전리되는 전하의 양을 측정한다. 미소 전류를 통한 누적선량 측정을 위한 고속 처리 알고리즘부는 입력 손실 없이 낮은 구현비용(전력)으로 X-선에 의해 전리되는 전하의 양을 측정한다. X-선 발생장치의 동작에 동기화된 유무선 송수신 프로토콜부는 통신 속도를 향상시킨다. 연동 및 에이징을 위한 PC 기반 제어 프로그램부는 실시간으로 발생된 X-선량을 측정하여 PC용 GUI를 통해 측정 그래프 및 수치 모니터링이 가능하도록 한다. 제안된 시스템의 성능을 공인시험기관에서 평가한 결과, 각각의 에너지 대역(30, 60, 100, 150kV)에서 면적선량계에 측정되는 값이 선형적으로 증가됨을 확인할 수가 있었다. 또한 4등분한 지점에서 측정기의 지시치에 대한 표준편차가 ${\pm}1.25%$를 나타내어서 면적선량계가 위치에 관계없이 균일한 측정값을 나타냄을 확인하였다. 한편, ${\pm}4.2%$의 불확도가 측정되어서 국제 표준인 ${\pm}15%$ 이하에서 정상동작 됨이 확인되었다.

• 한국전기전자재료학회:학술대회논문집
• /
• 한국전기전자재료학회 2002년도 추계학술대회 논문집 Vol.15
• /
• pp.440-443
• /
• 2002

Present1y the X-Ray diagnosis system is a real condition that is changing by digital ways in it's existent analog ways. This digital radiation detector is divided by the direct method and the indirect method. The indirect method of applied voltage has special qualities that the resolution is low than direct method by diffusion effect that happens. The conversion process ( radiation${\rightarrow}$visible ray${\rightarrow}$electrical signal of two times, has shortcomings that the energy conversion efficiency of electrical signal is low. The direct method has shortcomings that need strong electric fie1d to detect electrical signal efficiently. This research achieved to develop digital detector of the Hybrid method that have form that mixes two ways to supplement shortcoming of direct. indirect method. A studied electrical characteristic by Iodine's Mixture ratio change is added to selenium in the detector which has a multi-layer structure (Oxybromide + a-Se). There are 8 kinds of Manufactured compositions to amorphous selenium Iodine each 30ppm, 100ppm, 200 ppm, 300ppm, 400ppm, 500ppm, 600ppm, 700ppm by a doped photoconductor through a vacuum thermal evaporation method. The phosphor layer is consisted of Oxybromide ($BrO_2$) which uses optical adhesives multi-layer structure. The manufactured compositions calculates and compares Net Charge and signal to noise ratio measuring Photocurrent about Darkcurrent and X-ray. When doped Iodine Mixture ratio is 500ppm to the multi-layer structure (Oxybromide + a-Se), applied voltage of $3V/{\mu}m$, leakage current of compositions $2.61nA/cm^2$ and net charge value by 764pC/$cm^2$/mR then the best result appeared.

• 수산해양교육연구
• /
• 제26권6호
• /
• pp.1278-1295
• /
• 2014

The Sixteenth Meeting of the Conferences of Parties of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), which was held in March 2013 in Bangkok, Thailand, listed five shark species and one genus, and uplisted one sawfish species. All new species listings will be come into force of the eighteen months delay, on the fourteenth of September, 2014. The purpose of the delay is to support the preparation of the domestic measures on shark trade by the parties, as there has been no previous experience in trading the commercially exploited aquatic species in the CITES. The CITES Secretary-General has visited several potential shark trade countries to encourage and facilitate the implementation of the new CITES listings. The newly listed sharks have been caught as a target or non-target species by Korean distant water fisheries and introduced into Korea. So the establishment or change of the domestic laws, regulations, and measures for the implementation of the new CITES species must be prepared before the effective entry date. This paper is prepared to assess the effects of the trade of the CITES listed shark species, and to suggest effective government service measures for the management of Korean distant water fisheries. The Ministry of Environment (MOE) is the general Management Authority of the CITES, and the Ministry of Food and Drug Safety (MFDS) is in charge of the medical trade of CITES listed species in Korea. By law, all imported medicines and medical materials must be inspected by the MFDS during the customs examination; this kind of authority sharing is reasonable and effective way of providing government service. Similarly, the designation of new CITES Management Authority for the trade of commercially exploited aquatic CITES species is critical and the Ministry of Oceans and Fisheries (MOF), which is now in charge of the trade of fisheries products, is the most appropriate governing body for this purpose in Korea. The revision of the National Plan of Action for Conservation and Management of Sharks, initially submitted to the Food and Agriculture Organization (FAO) of the United Nations in 2011 as a practical guideline for shark conservation in all Korean fisheries, could be a effective measure to achieve unification of conservation of endangered species and sustainable use of fisheries stocks. The proper CITES measures for the trade of listed species, such as the establishment of the documenting system for Non-detriment Findings, domestic measures suitable for the "Introduction from the Sea" clause, species specific Harmonized System Codes for the customs service, and an effective shark catch data reporting system should be in place prior to the fourteenth of September 2014.

• Clinics in Shoulder and Elbow
• /
• 제10권1호
• /
• pp.84-91
• /
• 2007

목적: 총 7예의 금속형 요골 골두 치환술을 경험하여 적응증을 바탕으로 국내 요골두 치환술의 실태와 필요성을 소개하고자 하였다. 대상 및 방법: 2006년 4월부터 고려대학교 정형외과 교실에서 경험하였던 총 7예의 환자를 대상으로 수술 적응증, 수술 소견 및 수술 후 상태를 조사하였다. 그리고 치환물의 술 전 준비상태와 보험 적용 여부를 조사하였다. 금속형 치환물은 양극성 유형의 요골두 치환물(Tornier SA. Saint-Ismier, France)을 사용하였다. 결과: 전 예에서 요골두 분쇄 골절 이외에 $1{\sim}2$ 곳의 다른 골절 및 연부조직 손상을 동반한 복합 손상으로 요골두 치환술의 적응증에 해당되었다. 요골두 골절은 Mason 분류상 III형이 3예, IV형이 4예였고 분쇄골절로 인해 만족할만한 내고정을 얻지 못해 치환술을 시행하였다. 술 후 평가에서는 우수 2예, 양호 4예, 불량 1예였고 추시 시 치환물의 문제로 인한 합병증은 보이지 않았다. 술 전 수술 기구의 공급 부족으로 2예에서 수술 날짜를 변경하였고 치환물에 대한 비용은 산재 환자 2예를 제외한 5예에서 환자 개인이 부담하였다. 결론: 요골 골두의 분쇄를 포함한 주관절의 복합 손상에서 금속형 치환물은 술 전 계획 하에 준비되어야 하며, 의료보험의 적용으로 의사 및 환자들의 치료 선택에 도움을 주어야 할 것으로 생각되었다.

• 한국응급구조학회지
• /
• 제16권1호
• /
• pp.65-80
• /
• 2012

Purpose: The objective of this study was to assess the job satisfaction and turnover intention of the emergency medical technicians (EMT) in the private ambulance service, to examine their job satisfaction and turnover intention, and to provide the solution for the management of the private ambulance service. Methods: The survey was conducted with 121 EMTs (73 paramedics, 36 basic EMTs and 12 nurses) in the private ambulance service in Korea from September 15 to October 14, 2011. In the reliability of the questionnaire, Cronbach's ${\alpha}$ was 0.790 for job satisfaction and 0.796 for turnover intention. Using SPSS 18.0, we obtained Cronbach's ${\alpha}$, frequencies, percentages, means, and standard deviations, and performed independent t-tests, ANOVA, and Pearson's correlation analysis. Results: 1) The mean score with regard to job satisfaction was 2.94 and that of their turnover intention was 4.23. In the area of job satisfaction, the mean score of the job demand area was 4.23; 3.97 for the job itself; 3.07 for the area of interaction; 2.98 for the area of autonomy: 2.67 for the organizational demand area; 2.67 for working conditions area; and 1.73 for the wage area. 2) Statistically significant difference was observed in job satisfaction according to age (F=3.819, p=.006), wages (t=-4.640, p=.000), terms of incumbency (F=3.868, p=.011), and in turnover intention it was according to sex (t=-1.995 p=.048), age (F=9.611, p=.000), education levels (F=6.974, p=.002), marital status (t=4.393, p=.000), wages (t=5.515, p=.000), license types (F=8.481, p=.001), and terms of incumbency ( F=14.115, p=.000). 3) The job satisfaction and the turnover intention had a negative correlation to each other (r=-.56, p<.000) in general, and in the sub-7 areas of job satisfaction, the correlation with turnover intention was high in order of the wage area (r=-.61, p=.000), working conditions area (r=-.52, p=.000), the area of autonomy (r=-.49, p=.000), the area of interaction (r=-.45, p=.000), the organizational demand area (r=-.40, p=.000), the job itself (r=-.24, p=.007) and the job demand area (r=-.24, p=.009). Conclusion: The government must take the charge of lowering the turnover intention among paramedics in the private ambulance service by providing the advantage in wages and fringe benefits. Ultimately, this would bring an improvement in the quality of medical emergency services to hospitals especially in the area of patient transfer and transportation.

• Journal of Preventive Medicine and Public Health
• /
• 제14권1호
• /
• pp.3-12
• /
• 1981

To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

• 의료법학
• /
• 제16권1호
• /
• pp.155-190
• /
• 2015

법원은 2014년에도 의료와 관련된 의미 있는 판결들을 선고하였다. 법원은 수술 시 의료기구를 본래의 용도와 달리 사용하던 중 부러진 경우 이로 인한 사고에 의료진의 과실을 추정하였고, 설명의무와 관련하여 안전성이 검증되지 않은 수술을 시행하는 경우 설명의무 위반과 부작용 발생 사이의 인과관계를 인정하여 전손해배상이 인정될 수 있다는 점, 미용수술의 경우 일반적인 의료행위에 비하여 설명의무의 대상이 확대되어야 하는 점, 예상할 수 없는 범위에까지 설명의무를 인정할 수는 없는 점 등을 판시하였다. 또한 법원은 환자의 자기결정권과 의사의 진료의무 사이에 충돌이 발생한 경우 자기결정권 행사의 요건과 한계를 제시하였으며, 자동차보험계약이란 자동차사고와 관련된 배상 책임은 보험회사가 부담하기로 하는 계약이므로 비록 의료법에 위반되어 설립된 사무장 병원이라 하더라도 환자를 치료하고 보험금을 수령하는 것은 불법행위에 해당하지 않는다고 판시하였다. 의료기관 자체가 부당한 경제적 이익을 얻었을 뿐 의료기관 종사자들이 별다른 이익을 얻지 않은 경우, 리베이트 수수를 금지하는 의료법에 따라 의료기관 종사자들을 처벌할 수 없다는 견해를 밝힌 판결도 눈에 띈다. 그리고 법원은 업무정지처분을 받은 의료기관을 폐업하더라도 같은 장소에서 같은 운영자가 새로이 의료기관을 개설하는 경우 처분의 효과가 미친다고 판시하였고, 의사가 스스로 개설한 의료기관 외에서 진료행위를 할 수 있는 요건에 대하여 판시하였으며, 의료법을 위반한 혐의로 유죄 판결이 확정되기 전에는 이를 이유로 행정처분을 할 수 없다고 판시하였다.

• 한국치위생학회지
• /
• 제19권6호
• /
• pp.1025-1036
• /
• 2019

Objectives: The purpose of this study is to identify the status and opinions of professional oral health care performance in oral cancer patients. Methods: Seven National University Dental Hospitals and the National Cancer Center in Korea surveyed the medical personnel in charge of oral health care for oral cancer patients. The questionnaire consisted of 16 questions, including the status of expert oral health care education and performance for oral cancer patients, etc. A total of 47 questionnaires were retrieved, and the collected data were used in PASW Statistics 23.0 to perform frequency analysis, cross-analysis, and kruskal Wallis tests. Results: A survey of oral health care education found that 29.8% of the medical personnel had received education. The most performed of professional oral health care was found that applying fluoride by dental hygienist, treating stomatitis by dentist, and wiping mouths with sponge by nurse. The assessment of self-performance has shown that applying fluoride by dental hygienists has a statistically significant difference. Only 37.8% of oral health care education for patients was conducted. Most recognized that oral health care in oral cancer patients was important, but it is difficult to provide care due to lack of performance personnel and time, opportunities for performance personnel to be educated. The improvement was found to require an increase in the number of performance personnel, placement of professionals, and practical training to enhance performance capabilities. Conclusions: For oral health care of oral cancer patients, continuous education for medical personnel, establishment of oral health care manual and medical system, research on oral health care of oral cancer patients and public relations campaign will have to be activated. Development of expert care manual analysis and evaluation tools for oral health care in oral cancer patients in the future and development of standardized curriculum will be necessary.