• Radiation Oncology Journal
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• 제18권2호
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• pp.114-119
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• 2000

목적 : small bowel displacement system (SBDS)을 이용한 골반부 방사선 치료시 치료간(intertreatment) 및 치료중(intratreatment) 중심점 위치변동의 편차를 분석하고, 그 결과를 임상적으로 이용하고자 하였다. 대상 및 방법 :자궁경부암 7명, 직장암 4명의 총 11명의 환자를 대상으로 electronic portal imaging device (EPID)를 이용하여 302건의 후-전문(postero-anterior port) 영상과 232건의 측문(lateral port) 영상을 얻었다. 모든 환자는 복와위 자세로 하복부에 SBDS를 사용하였다 방사선 조사야의 중심점과 배율을 맞추기 위하여 5개의 금속 기준점을 영상탐지판(image detection unit)에 부착시켰으며, EPID 영상의 골 기준점(bony landmark)을 정하여 모의치료시 촬영한 영상과 비교하여 정렬시킨 후 우-좌문, 두-미문, 그리고 후-전문 방향으로 중심점의 이동방향 및 거리를 분석하였다. 결과 : 우-좌문, 두-미문, 그리고 후-전문 방향으로의 치료간 중심점 이동의 평균값은 각각 1.2 mm ($\pm$1.6 mm), 1.0mm ($\pm$3.0 mm), 0.9 mm ($\pm$4.4 mm)이었으며, 각 방향으로의 5 mm 이상의 치료간 중심점 이동은 각각 2, 12, 24$\%$, 그리고 10 mm 이상의 치료간 중심점 이동은 각각 0, 0, 5$\%$이었다 큰 폭의 위치변동을 보인 방향은 후-전문 방향이었으며, 최대값은 11.5 mm 이었다. 우-좌문, 두-미문, 그리고 후-전문 방향으로의 치료중 중심점 이동의 평균값은 각각 0 mm ($\pm$0.9 mm), 0.1 mm ($\pm$1.9 mm), 0 mm ($\pm$1.6 mm)이었다. 5 mm 이상의 치료중 중심점 이동은 각각 0, 1 , 1$\%$이었다. 결론 : SBDS를 이용한 골반부 방사선 조사시 폭과 빈도가 가장 큰 치료간 위치변동은 후-전문 방향이므로, 측면의 후-전문 방향으로 추가적인 여유를 두는 것이 바람직할 것으로 판단된다.

• 한국컴퓨터정보학회논문지
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• 제21권6호
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• pp.97-106
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• 2016

This study tries to seek the is the realistic improvements and legislative measures about current medical advertising which was in the Court on 12 May 2015 by presenting and discussion the understanding, problems and its alternative direction of pre-deliberation on the existing law which is the decision on the constitutionality of health care advertising regulated health care advertising General commercial advertising has the right which have to be protected as the terms of the protection of know and freedom of expression and advertiser's there are sure to be in a value to be protected. Medical advertising is also a person in addition to the absolute value that includes both Due to the particularity of medical advertising in terms of life and the right to health Until now, this has been the target of strong regulations are changing the policy of gradual deregulation in our country, including the country. Medical advertising on the current medical law had been to be checked by pre-deliberation of the executive power. However, due to unconstitutional, in the circumstances which a false hype is flooding and increasing, it has been realized that the fair competition of medical community, life and health rights of the people are threatened by in reverse. In this regard, the abolition of the pre-deliberation system of medical advertising can be welcomed by abolition of the old system which is the legal and institutional censorship. Since its abolition, the alternative policy direction is insufficient also it is not clear. Therefore we need to study this. Therefore, in this paper, we try to find general theoretical background and problem of pre-deliberation system of medical advertising. Also, as trying to find feasibility or ambiguity of regulation and issues about medical advertising on medical law, we argued the provision of special measures of the medical advertising for introduction of integrated medical advertising deliberation committee which can ensure the independence and autonomy, strengthening of the monitoring on the internet advertising, legal resolving through amendments, strengthening of penalties, and establish special measures of medical advertising for the medical privatization and demand for the foreign medical tourist, etc. Empirical study about practical regulatory measures of medical advertising which converged the various opinions of consumer groups, government and academia, and medical community, and we expect hope to see the more realistic alternative provision.

• Journal of International Society for Simulation Surgery
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• 제4권1호
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• pp.21-23
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• 2017

Purpose In this paper, we proposed alternate neighborhood system and reverse spread-direction approach for accurate and fast cellular automata-based image segmentation method. Materials and Methods On the basis of a simple but effective interactive image segmentation technique based on a cellular automaton, we propose an efficient algorithm by using Moore and designed neighborhood system alternately and reversing the direction of the reference pixels for spreading out to the surrounding pixels. Results In our experiments, the GrabCut database were used for evaluation. According to our experimental results, the proposed method allows cellular automata-based image segmentation method to faster while maintaining the segmentation quality. Conclusion Our results proved that proposed method improved accuracy and reduced computation time, and also could be applied to a large range of applications.

• 대한방사선치료학회지
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• 제24권2호
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• pp.175-181
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• 2012

목 적: Exactrac 6D couch system을 이용한 2D/2D 정합 결과를 분석하여 두경부암 환자의 방사선 치료 시 사용되는 Aquaplastic mask가 실제 임상에서 환자 위치 고정에 어떠한 영향을 미치는지 분석하고자 한다. 대상 및 방법: 본원에서 2010년 6월에서 2011년 6월까지 방사선치료를 받은 두경부암 환자 14명을 대상으로 Exactrac 6D couch system을 이용하여 2D/2D 정합을 통한 영상유도를 실시하였다. 영상 유도 후 획득한 6D 보정 결과 값들을 이용하여 각 값들의 상호 관계 연관성에 대하여 환자에 관련된 부분과 환자에 관련되지 않은 부분으로 나누어 분석하였다. 결 과: 전체 14명의 각 환자에 대한 보정 값들의 환자와 관련된 연관성 분석에서는 Longitudinal 방향과 Pitch 방향의 결정계수($R^2$)값이 0.76, Longitudinal 방향과 Yaw 방향은 0.48, Pitch 방향과 Yaw 방향은 0.42로 나타났으나 환자의 의존도를 제외한 분석에서는 위의 인자들에 대하여 0.03 이하의 값을 나타내었다. 결 론: Aquaplastic mask를 이용한 환자의 고정은 환자와 관련된 여러 가지 인자들로부터 영향을 받는 부분도 있지만 근본적인 mask 자체의 요인도 있음을 확인 할 수 있었다. 이에 대한 보정이 이루어질 경우 두경부암 환자의 치료에 있어 좀 더 정확한 치료가 이루어질 수 있으리라고 사료된다.

• 의료법학
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• 제20권2호
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• pp.141-171
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• 2019

간호사는 의료법 상 의료인으로서 의료기관에서 진료의 보조 등의 업무를 수행한다. 의료인인 간호사는 119 구조·구급에 관한 법률에 근거 구급대원으로서 병원 전 단계 응급의료체계에서 응급환자를 대상으로 응급의료를 제공한다. 병원 전 응급의료체계에서 업무를 수행하는 간호사의 업무범위는 의료법 상 포괄적으로 규정되어 있는 업무를 판례 등을 통해 구체화되어 왔다. 반대로 응급구조사의 업무범위는 응급의료법에 의해 구체적 행위를 열거하는 방식으로 규정되어 있다. 병원 전 단계 응급의료체계에서 응급의료종사자로서 업무를 수행하는 간호사의 업무범위는 대상 환자의 긴급성, 응급의료기관으로의 이송 중이라는 점, 통신 상의 의료지도라는 특수성을 고려하여 간호사의 업무범위를 의료기관 내에서와 달리 적용하여 해석되어야 한다. 따라서 상대적으로 병원 전단계에서 간호사가 응급구조사보다 넓은 업무범위가 인정되고 이것이 정책목표에도 부합된다.

• 대한치과의사협회지
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• 제48권1호
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• pp.6-11
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• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• 대한한의학원전학회지
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• 제28권3호
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• pp.27-43
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• 2015

Objectives : Zhang Zhong-jing's Shanghanlun is based on Six-channels system to classified a disease. This paper is planning to describe the Transmutation among Six-channels system. Six-channels change not fixed in either direction and each is relative to each other. Methods : I will try to describe the Transmutation among Six channels system, through the letter of the Shanghanlun. First, I will find letters related to a disease transmission. Second, It will be described through the analysis of the past medical scientists. Results : Six-Meridian Pattern is the categorization of syndromes according to the theory of the six meridians, applied to the diagnosis of acute febrile diseases at different stages, but also useful for the pattern syndrome differentiation of other diseases. Transmutation among Six channels system is not fixed in a certain order and it each affects one another. Conclusions : We can see that Zhong-jing's medical treatment from syndrome differentiation is associated with a Mutual transmission(相互傳變).

• 의학교육논단
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• 제20권2호
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• pp.72-77
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• 2018

Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.

• 동의생리병리학회지
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• 제28권1호
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• pp.9-15
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• 2014

Recently, interest in traditional medicine has increased steadily. Nations having traditional medicine system have been attempting to change it institutionally for the purpose of public application boost in use of traditional medicine. But there are not too many countries which have established the modern system of education and licensing system for traditional medicine with it maintained as a part of a national health care system. The best known examples of nations utilizing traditional medicine are the People's Republic of China, Republic of Korea, Japan, and Taiwan. These countries follow different patterns in the relationship with western medicine according to different social and historical backgrounds. Taiwan has dual medical system as Korean. In this study, we looked through history and the current state of affairs of national health care system in Taiwan, and also found out the licensing system, the educational system, and the curriculum in several universities. thoroughly. Furthermore, we looked into the direction of the policy of Taiwanese health care system which has been becoming an integrated medical system between traditional Chinese medicine and western medicine. With findings based on this study, we deduced implications of a future policy line about the integrated medical system in Korea to minimize conflicts between the concerned parties.

• 한국의학물리학회지:의학물리
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• 제13권3호
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• pp.135-138
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• 2002

치료대상 병소에 분할 방사선수술을 시술할 경우 회전중심(isocenter)은 정확하고 재현성 이 있어야 한다. 본 연구는 노발리스 방사선 수술장비와 정위 마스크 시스템을 사용한 분할방사선 수술에서 회전중심의 재현성을 측정하고 평가 하였다. 마스크는 열가소성 재질의 상용을 사용하였고 회전중심의 재현성을 측정하기 위해 고안된 머리 모양의 아크릴 팬텀에 맞도록 제작하였다. 팬텀의 내부에는 직경 5 mm의 아크릴봉을 수직으로 세우고 그 끝단을 회전중심으로 선택하였으며 예상되는 회전중심점에 pin hole을 낸 monochromic 필름을 설치하여 방사선 조사 후 회전중심의 재현성을 측정할 수 있도록 하였다. 측정 결과 회전중심은 공간오차가 평균 1 mm 이내이고 표준편차 또한 2 mm 이내여서 이미 보고된 타 문헌에서의 측정값과 비교해 볼 때 모든 측정값이 제시된 오차범위 내에 있었다. 결론적으로 분할방사선수술에 사용하는 정위 마스크 시스템은 매우 정확하고 재현성이 우수하였으며, 실제로 방사선 수술대상의 병소의 직경이 10 mm 정도 이상이라면 일반적인 한번의 고선량 방사선 수술에 정위 마스크 시스템의 사용이 가능할 것으로 사료된다.