• 대한치과기공학회지
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• 제30권2호
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• pp.105-119
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• 2008

This study explored the status of free time activities among the dental technicians who are working at Seoul, Gyonggido, and Gangwondo. On the basis of this research, we aim to present needs and applicable solutions to improve the working conditions and enhance the quality of life through more effective time management in free time activities that lead to their self development and far more enriched life. 500 subjects were randomly chosen and the questionary sheets were provided. Among them, 305 sheets were returned to be analysed through SPSS Win 10.0 software and the results are as follows; First, mean in the satisfaction of leisure activities was 3.44(SD=.73). Mean in sub categories was as follows; psychological factor(M=3.65, SD=.71), social factor(M=3.54, SD=.75), rest factors(M=3.52, SD=.63), physical factor(M=3.43, SD=.88), other factors(M=3.40, SD=.66), circumstantial factor(M=3.33, SD=.63), educational factor(M=3.24, SD=.73). Second, the most relevant sub categories in the satisfaction of leisure activities were social, educational, physical, and other circumstantial factors by sequence. Factors that affect leisure activities satisfaction were career and status of health, which shows statistical significance(p<.001). That is to say, contention of this study is that the general characteristics are closely related with and affect the types and the level of satisfaction in leisure activities of the subjects. Considering these results, the dental businesses and the associations of dental technicians should recognize the needs to improve the time management through more efficient cooperations between dentists and back office dental team, systemized working time, and introduction of incentive system among others. On the basis of this appreciation, the dental business should provide more time and various opportunities with the dental technicians. Dental technicians also need to reconsider their appreciations of leisure activities, that is, leisure activities are not just spending time doing something but they refresh them and enable them to be more active and faithful to home and work.

• 한방안이비인후피부과학회지
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• 제15권2호
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• pp.244-251
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• 2002

Introduction: SLE is autoimmune disease to appear systemic pathology in the connective tissue. Perniotic LE is sub-type of chronic dermal LE which causes purple macules on the terminal part of body-nose, ends of fingers, heals, calfs of the legs, elbows and knees. Objective: The purpose of this study was to estimate the efficiency of oriental medical treatment and management on the SLE and perniotic LE. Subject: We studied 2 patients who visited and hospitalized in Daejon University Oriental Hospital Dept. of Dermatology, with SLE and pemiotic LE from April 2002 till May 2002 Method: We treated them with herb medication, acupuncture and in addition to we consulted western medication if they were needed Results: In case of SLE patient, we considered it to be Yeol-Dok-Chi-Seong, so we priscriped Ga-Mi-So-Dok-Eum1, 2 , Yang-Dok-Baek-ho-Tang first. and till 22 days of hospitalization, we considered to be Gi-Eum-Yang-Heo and priscriped Ji-Hwang-Tang-Hab-Cheong-Sim-Yeon- Ja -Eum-Ga-Mi. but it wasn't adjust and high fever was reaccurred. And till 24 days of hospitalization we priscriped Gal-Geon-Hae-Gi-Tang, and becomed to 25 days, high fever was disappeared and the patient discharged and she has remained generally good condition. In case of Perniotic LE, at first we misdiagnosed her disease as a acral lentiginous melanoma, and we considered it to be Gan-Soo-Yeol-Li-Yeol- Jeung and priscriped Cheong-Pae-Sa-Gan-Tang and transferred her to another hospital, but she was diagnosed Perniotic LE Conclusion: Considering the above results, in case of SLE, in acute phase, we could treat her with oriental-western treatment, and in relief phase, we could treat her with only oriental treatment very efficiently. but in case of perniotic LE, we misdiagnosed it as a acral lentiginous melanoma, but we could experienced very rare perniotic LE case. And also further study is needed on the SLE, and perniotic LE, and we have to systematize of dyagnosis and treatment system.

• 한국콘텐츠학회논문지
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• 제19권8호
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• pp.303-315
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• 2019

2018년 한국의 65세 이상 노인 인구는 14.3%로 고령사회로 진입하게 되었으며 2025년 전후로 노인 인구가 20% 이상인 초고령사회로의 진입이 예상된다. 노인들의 경우 여러 의료기관을 방문하여 의약품을 복용하는 경우가 많아 각 약물 간의 상호작용 등의 약물 관리가 필요하다. 본 연구에서는 노인 약물관리 제도가 전문화되어 있는 미국의 제도와 초고령사회로의 진입을 앞두고 있는 한국의 제도를 분석하여 체계적인 노인 약물관리 방안을 모색하고자 하였다. 연구의 방법은 한국 및 미국의 노인 약물 관리에 관한 체계적인 문헌 연구를 진행하였다. 연구 결과 미국에서는 노인들에게 약물 치료 집중 관리제도(Medication Therapy Management, MTM)를 법제화하였고 노인 전문약사 제도를 운영하고 있었다. 한국에서는 노인 약물 관리를 위해 커뮤니티케어 사업을 진행하고 있지만 노인들이 더 안전하게 약을 사용하기 위해서는 노인 전문약사 제도가 필요한 것으로 분석되었다.

• 대한통합의학회지
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• 제6권4호
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• pp.149-169
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• 2018

Purpose : This study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the South Korea into 2030. Methods : In-and-out movement model was used to project the supply of physical therapists. The demand was projected according to the demand-based method which consists of four-stages such as estimation of the utilization rate of the base year, forecasting of health care utilization of the target years, forecasting of the requirements of clinical physical therapists and non-clinical physical therapists based on the projected physical therapists. Results : Based on the current productivity standards, there will be oversupply of 39,007 to 40,875 physical therapists under the demand scenario of average rate in 2030, undersupply of 44,663 to 49,885 under the demand scenario of logistic model, oversupply of 16,378 to 19,100 under the demand scenario of logarithm, and oversupply of 18,185 to 20,839 under the demand scenario of auto-regressive moving average (ARIMA) model in 2030. Conclusion : The result of this projection suggests that the direction and degree of supply of and demand for physical therapists varied depending on physical therapists productivity and utilization growth scenarios. However, the need for introduction of a professional physical therapist system and the need to provide long-term care rehabilitation services are actively being discussed in entering the aging society. If community rehabilitation programs for rehabilitation of disabled people and the elderly are activated, the demand of physical therapists will increase, especially for elderly people. Therefore, healthcare policy should focus on establishing rehabilitation service infrastructure suitable for an aging society, providing high-quality physical therapy services, and effective utilization of physical therapists.

• Investigative Magnetic Resonance Imaging
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• 제4권1호
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• pp.20-26
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• 2000

Gradient moment nulling techniques require the introduction of an additional gradient on each axis for each order of motion correction to be applied. The additional gradients introduce new constraints on the sequence design and increase the demands on the gradient system. The purpose of this paper is to demonstrate techniques for optimization of gradient echo gradient moment nulling sequences within the constraints of the gradient hardware. Flow compensated pulse sequences were designed and implemented on a clinical magnetic resonance imaging system. The design of the gradient moment nulling sequences requires the solution of a linear system of equations. A Mathematica package was developed that interactively solves the gradient moment nulling problem. The package allows the physicist to specify the desired order of motion compensation and the duration of the gradients in the sequence with different gradient envelopes. The gradient echo sequences with first, second, and third order motion compensation were implemented with minimum echo time. The sequences were optimized to take full advantage of the capabilities of the gradient hardware. The sequences were used to generate images of phantoms and human brains. The optimized sequences were found to have better motion compensation than comparable standard sequences.

• 대한방사선기술학회지:방사선기술과학
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• 제42권6호
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• pp.413-422
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• 2019

Heavy ion particle, represented carbon ion, radiotherapy is currently most advanced radiation therapy technique. Conventional radiation therapy has made remarkable changes over a relatively short period of time and leading various developments such as intensity modulated radiation therapy, 4D radiation therapy, image guided radiation therapy, and high precisional therapy. However, the biological and physical superiority of particle radiation, represented by Bragg peak, can give the maximum dose to tumor and minimal dose to surrounding normal tissues in the treatment of cancers in various areas surrounded by radiation-sensitive normal tissues. However, despite these advantages, there are some limitations and factors to consider. First, there is not enough evidence, such as large-scale randomized, prospective phase III trials, for the clinical application. Secondly, additional studies are needed to establish a very limited number of treatment facilities, uncertainty about the demand for heavy particle treatment, parallel with convetional radiotherapy or indications. In addition, Bragg peak of the heavy particles can greatly reduce the dose to the normal tissues front and behind the tumor compared to the photon or protons. High precision and accuracy are needed for treatment planning and treatment, especially for lungs or livers with large respiratory movements. Currently, the introduction of the heavy particle therapy device is in progress, and therefore, it is expected that more research will be active.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7459-7466
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• 2013

Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

• 대한족부족관절학회지
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• 제7권2호
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• pp.208-217
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• 2003

Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

• Journal of Oral Medicine and Pain
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• 제30권2호
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• pp.257-268
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• 2005

우리나라 건강보험제도는 보수지불방식에서 전체적으로 보면 행위별수가제(fee for service)를 유지하고 있다. 이 제도에서는 진료수가의 설계에서 각 의료서비스의 단위를 설정하기 위해서는 현재 임상에서 이루어지고 있는 모든 의료행위에 대한 목록이 필요하게 된다. 따라서 본 연구에서는 측두하악장애 의료의 수가구조와 수가항목에 대해 재분류를 통한 체계화과정을 통해서 향후 투입자원에 기초한 상대가치를 산정하여 수가수준을 결정할 수 있는 준거를 제시하고자 하였다. 현행 행위별 수가제도의 범위내에서 측두하악장애 진료행위에 대한 델파이법을 이용하여 의료행위에 대한 재분류하여 항목화 작업을 거치면서 자원기준 상대가치 산출모델의 선행연구를 시행하였다. 이를 통해 의료행위분류에서는 총 151개의 의료 행위를 규명하였다. 이를 건강보험 수가항목이 되도록 하기 위해서는 지속적인 정련화 과정이 필요하게 되므로 용어의 정리 및 통일, 명확한 진료범위의 설명, 체계적인 분류구조 등이 고려되어야 한다. 이상의 연구결과는 향후 치과의료의 구조적 문제점과 현안과제를 해결하는 기초자료로 활용하고, 앞으로 치과의료의 수가 수준을 결정하는 후속연구의 방향설정과 참고자료로 활용하며, 의료수가체계의 표준화를 유도하여 의료이용의 편의성을 도모하고 의료정책에 대한 국민적 신뢰를 회복하여 측두하악관절장애 진료의 건강보험 확대적용 및 향후 민간 사보험 도입시 기초자료로 활용될 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제22권4호
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• pp.542-554
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• 1989

The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.