• Journal of agricultural medicine and community health
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• v.26 no.2
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• pp.15-41
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• 2001

Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.123-129
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• 2013

Purpose: The way check the movement of the fiducial marker insertion in the treatment of patients with prostate cancer. However the existing methods of fiducial marker verification process difficult to identify the specific location of the marker behind the femur and pelvic bone. So to study the evaluation of maker match with using kilo voltage (KV) X-ray by On-board imager to both oblique verification method. Materials and Methods: Five patients were selected for rectal ballooning and inserted fiducial marker. Compare the position of the fiducial marker of reference plan 2D/2D Anterior/Posterior verification method and 2D/2D both oblique verification method. So to measurement the shift score of X, Y, Z (axis) and measure exposure dose given to patients and compare matching time. Results: 2 dimensional OBI KV X-ray imaging using two-dimensional matching image are orthogonal, so locating fiducial marker matching clear and useful DRR (digital reconstruction radiography) OBI souce angle ($45^{\circ}/315^{\circ}$) matching most useful. 2D/2D both oblique verification method was able to see clearly marker behind the pelvic bone. Also matching time can be reduced accordingly. According to the method of each matching results for each patient in each treatment fraction, X, Y, and Z axis the Mean $value{\pm}SD$ (standard deviation) is X axis (AP/LAT: $0.4{\pm}1.67$, OBLIQUE: $0.4{\pm}1.82$) mm, Y axis (AP/LAT: $0.7{\pm}1.73$, OBLIQUE: $0.2{\pm}1.77$) mm, Z axis (AP/LAT: $0.8{\pm}1.94$, OBLIQUE:$1.5{\pm}2.8$) mm. In addition, the KV X-ray source dose radiation exposure given to the patient taking average when AP/LAT matching is (0.1/2.1) cGY, when $315^{\circ}/45^{\circ}$ matching is (0.27/0.26) cGY. Conclusion: In conclusion for inserted fiducial marker of prostate cancer patients 2D/2D both oblique matching method is more accurate verification than 2D/2D AP/LAT matching method. Also the matching time less than the 2D/2D AP/LAT matching method. Taken as the amount of radiation exposure to patients less than was possible. Suggest would improve the treatment quality of care patients more useful to establish a protocol such as case.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.216-223
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• 2001

Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.

• Journal of Korean Society of Archives and Records Management
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• v.5 no.2
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• pp.27-48
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• 2005

This study investigates the current preservation and management of four records and documentary heritage in Korea that is in the UNESCO's Memory of the World Register. The study analyzes their problems and corresponding solutions in digitizing those world records heritages. This study also reviews additional four documentary books in Korea that are in the wish list to add to UNESCO's Memory of the World Register. This study is organized as the following: Chapter 2 examines the value and meanings of world records and documentary heritage in Korea. The registry requirements and procedures of UNESCO's Memory of the World Register are examined. The currently registered records of Korea include Hunmin-Chongum, the Annals of the Choson Dynasty, the Diaries of the Royal Secretariat (Seungjeongwon Ilgi), and Buljo- Jikji-Simche-Yojeol (vol. II). These records heritage's worth and significance are carefully analyzed. For example, Hunmin-Chongum("訓民正音") is consisted of unique and systematic letters. Letters were delicately explained with examples in its original manual at the time of letter's creation, which is an unparalleled case in the world documentary history. The Annals of the Choson Dynasty("朝鮮王朝實錄") are the most comprehensive historic documents that contain the longest period of time in history. Their truthfulness and reliability in describing history give credits to the annals. The Royal Secretariat Diary (called Seungjeongwon-Ilgi("承政院日記")) is the most voluminous primary resources in history, superior to the Annals of Choson Dynasty and Twenty Five Histories in China. Jikji("直指") is the oldest existing book published by movable metal print sets in the world. It evidences the beginning of metal printing in the world printing history and is worthy of being as world heritage. The review of the four registered records confirms that they are valuable world documentary heritage that transfers culture of mankind to next generations and should be preserved carefully and safely without deterioration or loss. Chapter 3 investigates the current status of preservation and management of three repositories that store the four registered records in Korea. The repositories include Kyujanggak Archives in Seoul National University, Pusan Records and Information Center of National Records and Archives Service, and Gansong Art Museum. The quality of their preservation and management are excellent in all of three institutions by the following aspects: 1) detailed security measures are close to perfection 2) archiving practices are very careful by using a special stack room in steady temperature and humidity and depositing it in stack or archival box made of paulownia tree and 3) fire prevention, lighting, and fumigation are thoroughly prepared. Chapter 4 summarizes the status quo of digitization projects of records heritage in Korea. The most important issue related to digitization and database construction on Korean records heritage is likely to set up the standardization of digitization processes and facilities. It is urgently necessary to develop comprehensive standard systems for digitization. Two institutions are closely interested in these tasks: 1) the National Records and Archives Service experienced in developing government records management systems; and 2) the Cultural Heritage Administration interested in digitization of Korean old documents. In collaboration of these two institutions, a new standard system will be designed for digitizing records heritage on Korean Studies. Chapter 5 deals with additional Korean records heritage in the wish list for UNESCO's Memory of the World Register, including: 1) Wooden Printing Blocks(經板) of Koryo-Taejangkyong(高麗大藏經) in Haein Temple(海印寺); 2) Dongui-Bogam("東醫寶鑑") 3) Samguk-Yusa("三國遺事") and 4) Mugujeonggwangdaedaranigyeong. Their world value and importance are examined as followings. Wooden Printing Blocks of Koryo-Taejangkyong in Haein Temple is the worldly oldest wooden printing block of cannon of Buddhism that still exist and was created over 750 years ago. It needs a special conservation treatment to disinfect germs residing in surface and inside of wooden plates. Otherwise, it may be damaged seriously. For its effective conservation and preservation, we hope that UNESCO and Government will schedule special care and budget and join the list of Memory of the Word Register. Dongui-Bogam is the most comprehensive and well-written medical book in the Korean history, summarizing all medical books in Korea and China from the Ancient Times through the early 17th century and concentrating on Korean herb medicine and prescriptions. It is proved as the best clinical guidebook in the 17th century for doctors and practitioners to easily use. The book was also published in China and Japan in the 18th century and greatly influenced the development of practical clinic and medical research in Asia at that time. This is why Dongui Bogam is in the wish list to register to the Memory of the World. Samguk-Yusa is evaluated as one of the most comprehensive history books and treasure sources in Korea, which illustrates foundations of Korean people and covers histories and cultures of ancient Korean peninsula and nearby countries. The book contains the oldest fixed form verse, called Hyang-Ka(鄕歌), and became the origin of Korean literature. In particular, the section of Gi-ee(紀異篇) describes the historical processes of dynasty transition from the first dynasty Gochosun(古朝鮮) to Goguryeo(高句麗) and illustrates the identity of Korean people from its historical origin. This book is worthy of adding to the Memory of the World Register. Mugujeonggwangdaedaranigyeong is the oldest book printed by wooden type plates, and it is estimated to print in between 706 and 751. It contains several reasons and evidence to be worthy of adding to the list of the Memory of the World. It is the greatest documentary heritage that represents the first wooden printing book that still exists in the world as well as illustrates the history of wooden printing in Korea.