• 농촌의학ㆍ지역보건
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• 제22권2호
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• pp.277-293
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• 1997

This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

• 대한소아치과학회지
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• 제40권4호
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• pp.274-282
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• 2013

이 연구는 2008년 1월부터 2012년 12월까지 소아치과에 내원한 7~15세 사이 아동 중, 파노라마방사선사진을 촬영한 3302명을 대상으로 하여 치아결손증의 유병률 및 선천적 결손치의 분포에 대해 분석하기 위함이었다. 치아결손증의 유병률은 남자(5.9%)가 여자(4.7%)보다 약간 높게 나왔으며, 남자에서 평균 선천적 결손치 수는 3.58개, 여자는 2.43개였다. 평균 선천적 결손치 수는 상악보다 하악에서 통계적으로 유의하게 높은 비율을 보였고(p < 0.05), 좌측과 우측치열간의 선천적 결손치 수의 차이는 통계적으로 유의하지 않았다(p > 0.05). 선천적 결손치가 가장 많이 분포하는 부위는 하악 제2소구치였으며 반대로 선천적 결손치가 가장 적게 분포하는 부위는 상 하악 제1대구치, 상악 중절치였다. 치아결손증 환자들에서 선천적 결손치의 악궁 내 대칭성 혹은 악궁 간 대칭성은 80.3%로 높게 나타났다. 이 연구의 결과는 임상의에게 선천적 결손치의 수와 위치에 대한 가치 있는 정보를 제공하여 정확한 진단을 내리고 바람직한 치료계획을 수립하는데 기여할 것이다.

• Journal of Radiation Protection and Research
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• 제36권1호
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• pp.28-34
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• 2011

세기조절방사선치료(Intensity Modulated Radiotherapy, IMRT)의 정도관리를 위해서 독립적인 방법으로 선량검증을 하는 것은 중요하다. 독립적 선량검증을 위해 팬톰과 이온전리함을 이용한 측정 방법이 보편적으로 이루어지지만 많은 시간과 노력이 요구된다. 본 연구에서는 세기조절방사선치료 시 시간에 따른 다엽콜리메이터의 움직임을 기록한 dynalog 파일을 이용하여 치료계획에서 도출된 총 실제 플루언스와 실제 치료 시의 모니터유닛(monitor unit, MU) 공간분포를 비교함으로써 간편한 세기조절방사선치료 정도관리 기술을 개발하였다. DICOM RT plan 파일로부터 총 실제 플루언스를 추출하고 MATLAB 코드를 이용하여 실제 치료 시 MU 공간분포를 dynalog 파일로부터 계산하였다. 개발된 방법의 효용성을 검증하기 위해 단계별조사기법과 동적조사기법으로 치료 받은 각 5명의 환자 데이터를 후향적으로 분석하였다. 분석 방법은 상용프로그램(Verisoft 3.1, PTW, German)에서 제공하는 감마인덱스를 사용하였다. 분석 결과 실제 치료 시의 MU 공간분포와 치료계획 상의 MU 공간분포 일치도가 평균 $97.8{\pm}1.33$%로 높은 일치도를 나타냈다. MU 공간분포 재구성의 정확도는 동적조사기법보다 단계별조사기법이 평균 1.4% 높았다. 본 연구에서 개발된 기술을 통해 세기조절방사선치료의 선량검증을 효과적으로 수행할 수 있다. 또한 분할치료 시 선량보정에 적용함으로써 맞춤형치료(adaptive radiotherapy)를 위한 기초자료로 사용될 수 있을 것이다.

• 한국의학물리학회지:의학물리
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• 제29권2호
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• pp.59-65
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• 2018

This paper describes the clinical use of the dose verification of multileaf collimator (MLC)-based CyberKnife plans by combining the Octavius 1000SRS detector and water-equivalent RW3 slab phantom. The slab phantom consists of 14 plates, each with a thickness of 10 mm. One plate was modified to support tracking by inserting 14 custom-made fiducials on surface holes positioned at the outer region of $10{\times}10cm^2$. The fiducial-inserted plate was placed on the 1000SRS detector and three plates were additionally stacked up to build the reference depth. Below the detector, 10 plates were placed to avoid longer delivery times caused by proximity detection program alerts. The cross-calibration factor prior to phantom delivery was obtained by performing with 200 monitor units (MU) on the field size of $95{\times}92.5mm^2$. After irradiation, the measured dose distribution of the coronal plane was compared with the dose distribution calculated by the MultiPlan treatment planning system. The results were assessed by comparing the absolute dose at the center point of 1000SRS and the 3-D Gamma (${\gamma}$) index using 220 patient-specific quality assurance (QA). The discrepancy between measured and calculated doses at the center point of 1000SRS detector ranged from -3.9% to 8.2%. In the dosimetric comparison using 3-D ${\gamma}$-function (3%/3 mm criteria), the mean passing rates with ${\gamma}$-parameter ${\leq}1$ were $97.4%{\pm}2.4%$. The combination of the 1000SRS detector and RW3 slab phantom can be utilized for dosimetry validation of patient-specific QA in the CyberKnife MLC system, which made it possible to measure absolute dose distributions regardless of tracking mode.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1061-1065
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• 2013

Objective: To investigate the treatment effect of additional information obtained by single photon emission computed tomography (SPECT) lung perfusion imaging (LPI) in the radiotherapy planning process for patients with stage III non-small cell lung cancer (NSCLC). Methods: 39 patients with stage III NSCLC were enrolled. Gross tumor volume (GTV) was outlined by SPECT/CT images, SPECT-LPIs being used to define functional lung (FL) and non-functional lung (NFL) regions. Two sets of IMRT plans were designed to deliver 64Gy to PTV. One was a regular IMRT plan using CT images only (Plan 1), and the other was a corresponding IMRT plan using co-registered images (Plan 2). $FL_{Vx}$ (the % volume of functional lung receiving ${\geq}$x Gy) and $WL_{Vx}$ (% volume of whole lung to receive ${\geq}$x Gy) were compared by paired Student's t test. Kendalls correlation was used to analyze the factor (s) related with the FLV20 decrease. Results: Compared with plan 1, both $WL_{Vx}$ and $FL_{Vx}$ were decreased in plan 2. $WL_{V10}$, $WL_{V15}$, $WL_{V20}$, $WL_{V25}$, $WL_{V30}$ and $WL_{V35}$ decreased 9.7%, 13.8%, 17.2%, 12.9%, 9.8% and 9.8%, and $FL_{V10}$, $FL_{V15}$, $FL_{V20}$, $FL_{V25}$, $FL_{V30}$ and $FL_{V35}$ decreased 10.8%, 14.6%, 17.3%, 14.5%, 14.5% and 10.5%. $FL_{Vx}$ decreased significantly compared with $WL_{Vx}$. There were significant differences in $WL_{V10}$, $WL_{V15}$, $WL_{V20}$, $WL_{V25}$, $WL_{V3}$ and $FL_{V10}$, $FL_{V15}$, $FL_{V20}$, $FL_{V25}$, $FL_{V30}$ between plan 1 and plan 2 (P=0.002, 0.000, 0.000, 0.005, 0.027 and 0.002, 0.000, 0.000, 0.006, 0.010). According to Kendall correlation analysis, NFL had a negative relation with the percentage FLV20 decrease (r=-0.559, P<0.01), while the distance of PTV and NFL center had a significantly positive relation with the percentage of FLV20 decrease (r=0.768, P<0.01). Conclusion: Routine use of SPECT-LPI for patients undergoing radiotherapy planning for stage III NSCLC appears warranted.

• 한국의학물리학회지:의학물리
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• 제24권1호
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• pp.41-47
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• 2013

부피효과를 가지는 2차원 배열형 이온함으로부터 측정된 세기조절방사선치료의 선량분포와 부피효과를 가지지 않는 장치로부터 측정된 선량분포를 비교함으로써 이 효과가 측정결과에 미치는 영향에 대해 평가하였다. 조사면 크기에 따라 총 5개의 세기조절방사선치료계획을 5문 조사방식으로 가상의 팬톰에 시행하였다. 선량분포 측정은 매트릭스 팬톰, 빔 영상시스템, 필름 등 총 3가지 측정장치를 이용하였다. 측정된 값은 분석프로그램을 이용하여 전산화치료계획 시스템을 통해 획득된 선량분포와 비교하였다. 비교된 선량분포는 분석프로그램 상에서 상관계수와 감마값을 통해 측정장치의 부피효과 유무에 따른 차이를 분석한 결과 매트릭스 팬톰에서 최대 1.3% 이상으로 나타났다. 매트릭스 팬톰은 조사면의 크기가 작아질수록 내부의 이온함에 의해 부피효과가 커지게 되므로 다른 측정장치에 비해 더 큰 측정오차를 가지는 것으로 판단되었다.

• 한국재난정보학회 논문집
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• 제16권1호
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• pp.34-43
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• 2020

연구목적: 본 연구는 소방공무원 보건안전 및 복지기본계획, 그리고 매년 연도별 계획이 실질적으로 소방공무원의 보건과 복지에 기여하는지 여부를 실증검증하여 현재 계획에 근거한 정책들의 문제점과 개선방안을 도출하고자 하였다. 연구방법: 현황분석과 더불어 해당분야 전문가들로부터의 델파이분석기법에 의해 연구결과: 소방공무원 보건안전정책에서의 문제점으로 소방관 전문병원의 부재, 일선 소방서차원의 정신건강교육프로그램 미흡, 현장활동 위험평가 체계 미흡의 문제, 심신건강관리사업의 효과성 문제, 심신안정 프로그램의 내실화 부족, 정신건강관련 교육의 부재, 정신건강관련 프로그램 이용자의 은닉성 보장문제가 주요 문제점으로 도출되었으며, 소방공무원 복지정책에서의 문제점으로 부모소방관에 대한 지원부족, 퇴직소방관에 대한 노후설계대비 미흡, 여성소방관에 처우개선 미흡이 도출되었다. 결론: 개선방안으로 소방전문병원설립, 정신건강교육프로그램의 내실화 및 소방서내 CISD 리더 양성프로그램 마련, 재난현장 위험평가체계의 마련, 찾아가는 심리상담실사업등에 대한 효과성 측정등의 평가체계 도입, 수요자 만족도 조사등을 통한 프로그램 내실화, 정신건강관련 교육시스템 마련, 인사시스템 개선을 통한 은닉성 보장 방안, 육아 휴직제도 장려 및 소방서내 육아시설 도입, 퇴직소방관 활용 방안 수립 및 사업 활성화, 여성소방공무원을 위한 정책마련 방안이 도출되었다.

• 대한예방한의학회지
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• 제21권3호
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• pp.11-18
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• 2017

Objectives : In an effort to suggest a developmental plan of Traditional Korean Medicine health promotion project(TKM-HPP), this study was conducted to identify the problems experienced by public health Traditional Korean Medicine(PH-TKM) doctors in duty and to analyze successful cases of the health promotion project. Methods : Two PH-TKM doctors in duty at the Public Health Centre branch and Public Health Centre respectively, and one TKM doctor in charge of Public Health Centre participated in the in-depth interview. The research procedure was as follows; 1) inform study objectives and interview questions to participants, 2) in-depth interview with semi-structured questions, and 3) post-confirmation and verification. The interview was recorded and transcripted. In-depth interview was composed of 6 subsections: 1) Introducing participants and share purpose of interview, 2) Confirmation of the job status and difficulty of public health centre, 3) Reflecting and sharing experiences of public health clinic job performance cases, 4) Current status and improvement needs of TKM-HPP, 5) Discussions on improvement of TKM-HPP in public health center, 6) Sharing and reconfirmation of interview results. Thematic analysis was conducted from the narratives. Results : The study showed that; 1) the support from the local government was critical for the successful TKM-HPP and participation of the PH-TKMs; 2) the major problems experienced by PH-TKMs were lack of training for TKM-HPP in the field and lack of knowledge at local government level; 3) the suggestions to provide PH-TKMs with manual to educate residents effectively and redefine roles of PH-TKMs in the project. It also suggests that TKM-HPP model should be developed by the district in a way of reflecting regional characteristics. Conclusions : Firstly, more efforts should be made on the projects rather than medical treatment in public health centers, except for areas where medical institutions are scarce. Secondly, in order to facilitate participation of PH-TKM doctors, each local office should reduce medical care and increase efforts related with projects. Thirdly, the institution has to develop feasible TKM-HPP plans that can be carried out by PH-TKMs by the manual. Lastly, pre-training should be provided to PH-TKMs to understand contents of TKM-HPP related to public health centre work before the placement.

• 대한핵의학회지
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• 제30권4호
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• pp.502-506
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• 1996

연구 목적 : 디피리다몰 부하-휴식 Tc-99m MIBI 일일 심근영상법에서 부하기 영상이 정상인 환자에서 휴식기 영상이 필요한지 알아보고자 하였다. 대상 및 방법 : 흉통을 주소로 전남대학교병원을 내원하여 핵의학과에서 디피리다몰 부하/휴식 MIBI 심근관류 SPECT를 시행한 환자 중 부하시 스캔 소견상 관류결손이 없었고, 심근관류검사 전후 1개월 이내에 관동맥조영술로 관동맥병변 유무가 확진된 43명의 환자(남:여=24:19, 평균연령 $52{\pm}11세$)를 대상으로 하였다. 촬영방법은 디피리다몰 부하-휴식 Tc-99m MIBI 일일 심근영상법을 사용하였다. 결과 및 결론 : 부하기 영상이 정상인 환자 중 관동맥질환이 없는 경우 휴식기에도 정상으로 나올 확률은 79% (23/29)였고, 새로운 관류결손이 나올 확률은 21%였다. 부하기 영상이 정상이면서 관동맥질환이 있는 환자에서 휴식기 영상으로 새로운 결손을 찾아낼 확률은 22%였다. 따라서, 흉통을 호소하는 환자에서 부하기 영상이 정상일때 휴식기 영상은 대체로 추가적인 정보를 주지 못한다는 것을 알 수 있었다. 그러나, 관동맥경련이 있는 환자는 5명 중 4명(80%)에서 휴식기 영상에 새로운 관류결손이 보일 수 있으므로, 관동맥경련이 의심되는 환자에서는 휴식기 영상을 촬영할 필요가 있을 것으로 사료되었다.

• 한국치위생학회지
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• 제13권1호
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• pp.69-81
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• 2013

Objectives : The purpose of this study was to examine whether the subjective oral health awareness and oral health behavior of Korean adults would affect their oral health indexes. It's meant to utilize existing data of epidemiological and alternative indexes in an effort to have a comprehensive and understanding of the relationship between the subjective oral health awareness and oral health behavior of Korean adults. And the following findings were obtained Methods : The subjects in this study were 7,285 adults who were selected from the third-year(2009) raw data of the fourth national health & nutrition survey. Results : As for the relationship between oral health awareness and oral health indexes, there were statistically significant differences in DMFT index, FS-T index, T-health index and CPI index according to self-rated health status, self-rated oral health state, necessity of dental treatment and oral health concern. Concerning the relationship between oral health behavior and the oral health indexes, whether they got a dental checkup over the past year, daily toothbrushing frequency, use or nonuse of oral health supplies and mastication problems made statistically significant differences to DMFT index, FS-T index, T-health index and CPI index. The variables that had a significant impact on oral health were selected from among the variables of oral health awareness and oral health behavior that affected oral health, and the variables were selected as independent variables. And then the oral health indexes were selected as dependent variables, and a multiple regression analysis was carried out by using the selected independent and dependent variables. As a results, it's found that the variables made a 22.4% prediction of DMFT index; 51.3% for FS-T index; 52.0% for T-health index; 47.4% for CPI index. Conclusions : The above-mentioned findings illustrated that the relationship between the subjective oral health awareness and oral health behavior of the Korean adults exercised an influence on their oral health indexes. Accurate and effective oral health plans should be mapped out by grasping the oral health status of adults from diverse angles to facilitate the maintenance and promotion of their oral health status.