• 대한방사선기술학회지:방사선기술과학
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• 제30권4호
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• pp.313-320
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• 2007

[ $\ulcorner$ ]의료기사 등에 관한 법률$\lrcorner$에는 다수 직종을 총괄하여 규정하고 있어 방사선사 업무의 전문성 향상과 방사선의료기술에 대한 국민의 건강권을 보장하기 어렵다. 따라서 방사선사에 관련된 법령을 개별적으로 제정하는것이 요청된다. 개별법으로서 방사선사법은 궁극적으로 국민의 건강증진을 목적으로 하는 방사선사의 책임규제에 관한 법으로 제정되어야 한다. 이를 위해 전문방사선사에 대한 규정을 신설하고 보수교육과 면허관리제도의 강화를 통하여 국민들이 보다 수준 높은 양질의 방사선의료기술을 제공받을 수 있도록 하여야 한다. 또한 방사선사의 역할과 업무를 명확히 규정하여 국민에게 제공되는 의료방사선서비스의 질적 수준을 확보하여야 한다. 정부기관에는 의료방사선정책심의위원회를 두어 의료방사선의 안전관리와 방사선사 인력의 수급, 기타 의료방사선정책에 관한 중요한 사항이 검토되고, 심의되어야 한다. 그밖에 방사선조사선량의 기록, 관리를 통하여 방사선피폭으로부터 국민의 건강보호를 위한 규정도 필요하며, 팀의료의 일원으로서 방사선사의 지위가 보장되어야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1887-1893
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• 2012

The aim of this study was to detail characteristics of mammary Paget's disease (PD) representing the whole population in China. A total of 4211 female breast cancer inpatients at seven tertiary hospitals from seven representative geographical regions of China were collected randomly during 1999 to 2008. Data for demography, risk factors, diagnostic imaging test, physical examination and pathologic characters were surveyed and biomarker status was tested by immunohistochemistry. The differences of demography and risk factors between PD with breast cancer and other lesions were compared using Chi-square test or t-test, with attention to physical examination and pathological characters. The percentage of PD was 1.6% (68/4211) in all breast cancers. The mean age at diagnosis was 48.1, and 63.2% (43/68) patients were premenopausal. There is no difference in demography and risk factors between PD with breast cancer and other breast cancer (P > 0.05). The main pattern of PD in physical exam and pathologic pattern were patients presenting with a palpable mass in breast (65/68, 95.6%) and PD with underlying invasive cancer (82.4%, 56/68) respectively. The rate of multifocal disease was 7.4% (5/68). PD with invasive breast cancer showed larger tumor size, more multifocal disease, lower ER and PR expression and higher HER2 overexpression than those in other invasive breast cancer (P < 0.05). These results suggested that PD in China is a concomitant disease of breast cancer, and that PD with underlying invasive cancer has more multiple foci and more aggressive behavior compared with other breast invasive cancer. We address the urgent needs for establishing diagnostic and therapeutic guidelines for mammary PD in China.

• 동의생리병리학회지
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• 제28권4호
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• pp.430-439
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• 2014

This study was performed to assess the perception and needs of the traditional Korean Medical Equipment (KME) in clinic. We conducted survey research among 15,550 traditional Korean medical doctors (KMD) responded to e-mail during 2 weeks. 899 participants the survey, consisting of questions regarding 'number of devices of the KME' and 'solution and improvement plan of the KME'. The participants were asked to choose their ranking of problems of the KME and also put a check mark in the column that the reasons for this choice. As results, final scores in priority ranking medical devices were derived in 7 categories. Physical therapy equipment and acupuncture treatment devices were included in high ranks. 42.8 % of the participants responded that the diagnostic medical devices seemed important in clinics and 67.4 % of the participants indicated that the therapeutic medical devices seemed to important in clinics. The identified problems of KME were 'low reproducibility and reliability of a diagnosis result (24.8%)' and 'uncertain validity of a diagnostic medical devices (20.5%)'. The improvement plan of the problems were 'to establish the law for using the medical devices (26.6%)' and 'evaluation of validity of the KME (26.2%)'. A survey of KMD revealed the condition of KME's number of devices and the solution plan for the problem of several KMEs. Understanding the needs of KMD could probably contribute to the research and development of KMEs in the future.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 2003년도 제45차 추계학술대회
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• pp.21-30
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• 2003

As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameter are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and technique for sperm harvesting. In addition, potential genetic causes of male subfertility should be diagnosed and discussed with the patient. Cystic fibrosis gene mutation, karyotype abnormallities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. With recently evolved diagnostic and therapeutic techniques now available for the infertile couple, even the most severe male factor problems in patients previously considered irreversibly infertile are now potentially treatable. The physician should be aware of the availability and limitations of these new and exciting reproductive technologies because they will allow him to provide timely and more effective therapy for the infertile couple. An understanding of these advances by all physicians is important as we progress into the $21^{st}$ century

• 대한영상의학회지
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• 제83권3호
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• pp.699-704
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• 2022

급성 산후 자궁내번증은 드문 산후합병증의 하나이나 생명을 위협할 수 있어 신속한 진단 및 적절한 치료가 중요하다. 다량의 출혈은 부분 자궁내번증을 진단하는데 어려움을 야기하며 치료를 지연시킬 수 있다. 본 증례는 다량의 산후 출혈을 주소로 온 32세 산모를 자궁동맥색전술을 통해 내번된 자궁의 기저부를 따라서 아래쪽으로 기울어져 주행하는 자궁동맥의 특이적인 주행을 발견하여 자궁내번증으로 빠르게 진단할 수 있었던 증례이다. 이를 통해 자궁동맥색전술은 효율적인 치료를 위한 중재시술뿐만 아니라 자궁내번증의 진단적 도구로 가치가 있음을 보여준다.

• Pediatric Infection and Vaccine
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• 제21권2호
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• pp.104-113
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• 2014

목적: 본 연구는 최근 10년 동안 전주 예수병원에 쯔쯔가무시병으로 입원한 환자를 조사하여 소아와 성인의 임상 양상을 비교하고자 하였다. 방법: 2003년 1월부터 2012년 12월까지, 쯔쯔가무시병의 진단 기준에 포함되는 768명의 환자를 후향적으로 검토하여, 소아 49명, 성인 719명의 임상적 특징과 검사소견 및 합병증 등을 분석 비교하였다. 결과: 연도별 환자의 증가 추세는 소아와 성인 모두에서 뚜렷하게 보이지 않았고, 10월과 11월에 환자가 가장 많이 발생하였다. 남녀비에서 소아는 남아가 많은 반면에, 성인은 여자가 많았고, 거주 지역은 소아가 성인에 비해 도시가 더 많았다. 증상은 소아에서 발진과 가피가 많았고, 근육통은 성인에서 더 많았다. 검사상 소아는 빈혈이 많은 반면에, 혈소판, 간기능, 신기능의 이상 소견이 적었다. 입원 기간과 합병증에서는 성인보다 양호한 결과를 보였다. 소아에서 독시사이클린과 마크로라이드계열 항생제의 치료 효과를 비교하였을 때, 두 약제 간에 유의한 차이는 보이지 않았다. 결론: 쯔쯔가무시병 환자에서 소아는 남아에서 많았고, 발진 및 가피의 발생이 더 많았다. 검사상 이상 소견은 성인에 비해 경하였으며, 입원 기간이 짧고, 합병증이 적으며, 마크로라이드계열 항생제에도 동일한 치료 효과를 보였다. 따라서 유행 시기에, 소아에서 쯔쯔가무시병이 의심될 때에는, 세밀한 이학적 진찰과 혈청학적 검사를 실시하여 빠른 진단을 내릴 수 있도록 노력해야 하며, 상대적으로 부작용이 적은 마크로라이드계 항생제로도 좋은 치료 결과를 기대해 볼 수 있다.

• 한국임상수의학회지
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• 제22권1호
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• pp.56-59
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• 2005

5개월령의 암컷 토끼가 소양증, 탈모 및 점액화농성 안루로 내원하였다. 전신에서 경미에서 중등도 인설이 관찰되었다. 안면부, 이개내측, 사지 중수골과 중족골의 내측, 좌측슬관절 앞쪽의 탈모, 발적, 구진, 농포와 가피등의 다양한 피부병변이 나타났다. 채취된 인설의 현미경 검사에서 다수의 Cheyletiella spp가 관찰되었다. 다수의 이염색성 백혈구, 호산구 및 림프구가 세포학적 검사에서 나타났으며 곰팡이 배양검사는 음성이었다. 세균배양결과 Pasteurella spp가 검출되었다. 검사결과에 따라 Cheyletiella 피부염으로 진단하였다. 치료는 selamectin 6mg/kg을 2주 간격으로 2회 국소 적용하였으며 치료 1개월 후에 임상증상이 현저하게 경감되었고 피부병변은 대부분 정상으로 회복하였다. 따라서 selamectin의 국소적용은 토끼의 Cheyletiellosis의 치료에 효과적인 것으로 판단되었다.

• 한국임상수의학회지
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• 제28권2호
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• pp.258-261
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• 2011

8연령의 암컷 요크셔 테리어견이 요실금을 주증으로 내원하였다. 환축은 요실금 증상이 나타나기 이전부터 다음다뇨 증상을 가지고 있었으며, 난소제거 8개월 이후 야뇨증이 나타났다. 신체검사 상에서 비만과 고혈압이 확인되었다. 실험실 검사에서 적혈구증가증, 지질혈증 및 간수치 증가가 관찰되었다. 다양한 검사를 통하여 난소제거 이후 발생한 요도 괄약근 기능부전증이 가장 의심되었다. 이와 더불어 본 환축은 부신피질기능 항진증을 가진 것으로 진단되었다. 합성 에스트로겐인 디에틸스틸베스테롤을 통한 치료적 접근에서 요실금 증상의 개선이 확인 되었으며, 이를 통하여 요도 괄약근 기능부전증이 요실금의 원인으로 확진 되었다. 결론적으로 본 증례는 부신피질기능 항진증과 더불어 암캐의 난소 제거 이후 발생한 요도 괄약근 기능부전의 임상증상과 실험실 검사 결과 그리고, 치료 반응에 대한 국내 첫 증례보고이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.