• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.105-124
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• 2023

Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.337-343
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• 2014

Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.4
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• pp.403-411
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• 2017

The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.23-27
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• 2018

Purpose The introduction of bone scan has been reported as a useful tool in the diagnosis, treatment, and treatment response of skeletal disease. The purpose of this study is to improve the anatomical information and tolerance of the bone by combining bone scan and pelvic X-ray without additional radiation exposure. Materials and Methods From November 2015 to August 2016, 236 patients(64 men and 172 women, average age $50.96{\pm}15.39years$) take Bone scan and Pelvis AP(Anteroposterior) X-ray scan at the National Cancer Center. The scan equipment was a gamma camera, Symbia Ecam (SIEMENS, Germany), and a digital x-ray, DRS-800 (Listem, Korea). Osirix version 3.8.1 (Osirix, USA) and Stata/SE version 14.0 (StataCorp, USA) were used for image combination and analysis. The patient was intravenously injected with $^{99m}Tc-DPD$ (740 MBq), and the scan was performed 2 to 4 hours later. Gamma camera image acquisition were Matrix size $256{\times}1024$, Zoom 1.00, and scan speed 17 cm/min. The digital X-ray was made with a collimator size of $14^{{\prime}{\prime}}{\times}17^{{\prime}{\prime}}$, 77 kVp (60 to 97 kVp) and an average of 30 mAs (20 to 48). ASIS and pubic symphysis Select virtual points then Combine three virtual points and pelvic contour lines. The acquired images were evaluated by three radiologists who worked for more than 5 years in the nuclear medicine department. Results Of the total 236 patients, 216 (91.53%) were matched. The median and range (min~max) of the age were 67 (46~81) years old in the unmatched group and 52 (22~87) years old in the matched group, The Wilcoxon rank-sum test was performed to determine whether age was different between the two groups. As a result, the age difference between the two groups was statistically significant at p < 0.0001. Of the 64 men, 60 (93.75%) were match and of the 172 women, 156 (93.75%) were match. There was no statistically significant difference according to gender(p = 0.4542). Of the 54 patients without pelvic lesions, 54 (100.00%) were match, and 162 (89.01%) of 182 patients with pelvic lesions were match. There was a statistically significant difference according to the presence of pelvic lesions. Conclusion There are many variables in the combination of bone scan and pelvic X-ray imaging, and the patient's age and pelvic lesion may have some effect on the image combination. This study is expected to be useful for the diagnosis of pelvic osteosarcoma of children without radiation exposure. It is expected that this combination of images will help to develop the nuclear medicine image.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.105-111
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• 2005

Purpose : Daily Q.A is the important step which must be preceded in a radiation treatment. Specially, radiation output measurement and laser alignment, SSD indicator related to a patient set-up recurrence must be confirmed for a reasonable radiation treatment. Daily Q.A proceeds correctness and a prompt way, and needs an objective measurement basis. Manufacture of the device which can facilitate confirmation of output measurement and appliances check at one time was requested. Materials and Methods : Produced the phantom formal daily check device which can confirm a lot of appliances check (output measurement and laser alignment. field size, SSD indicator) with one time of set up at a time, and measurement observed a linear accelerator (4 machine) for four months and evaluated efficiency. Results : We were able to confirm an laser alignment, field size, SSD indicator check at the same time, and out put measurement was possible with the same set up, so daily Q.A time was reduced, and we were able to confirm an objective basis about each item measurement. As a result of having measured for four months, output measurement within ${\pm}2%$, and measured laser alignment, field size, SSD indicator in range within ${\pm}1mm$. Conclusion : We can enforce output measurement and appliances check conveniently, and time was reduced and was able to raise efficiency of business. We were able to bring a cost reduction by substitution expensive commercialized equipment. Further It is necessary to makes a product as strong and slight materials, and improve convenience of use.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.73-78
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• 2015

Purpose : Under the assumption of change to the amplitude based sorting, the study will use four dimensional computed tomography imaging (4DCT) arrayed using the phase based sorting to analyze the respiratory phase difference. Materials and Methods : The study analyzed the 4DCT (4-dimensional computed tomography) images of 10 liver cancer patients that were treated with respiratory gated radiotherapy from 2015 February to March. Using RPM respiratory gating (RPM 1.7.5, Varian, USA) equipment, imaging according to respiratory cycle of phase based sorting was acquired and using a treatment planning system (Pinnacle 9.2, Philips, USA) the acquired imaging according to respiratory cycle was used to measure the abdominal movement value by respiratory cycle. The measuring point was the point where the center point of the Marker Block and the body surface met in the 50% phase image and here the coordinate values Lateral, Vertical, Longitudinal (X, Y, Z) were set as reference points, and on the X, Z plane identical to the reference point, using the identical method the Y axis coordinate value of each 0%, 30%, 40%, 50%, 60%, 80% phase images were acquired to quantitatively measure the variation of distance to the Y axis. The abdominal movement value according to respiration was applied to the theoretical model that the value decreases linearly from maximum inhalation to maximum exhalation to divide the variation of my value to predict as amplitude value by respiratory cycle and conversely the variation in amplitude was recalculated with the phase variation deviation value to analyze. Results : The deviation value between expected value and actual location was the largest in the 30% phase with 0.24 cm, and standard deviation was also the largest in 30% phase with 0.13 cm. The effective value of the deviation value derived from the average of the deviation squared value of each patient appeared as minimum 0.7 cm, maximum 0.18 cm, average 0.12 cm, and standard deviation 0.4 cm. Also by dividing the actual movement distance value with the peak expiration value then converting it into %Phase, the deviation value with actual phase 16.5% in 30% phase, 10.0% and 40% phase, 10.0% and 60% phase, 15.4% and 80% phase, and overall average about 13%, and arraying based on amplitude, phase shift occurred and further it was from peak expiration the chance of deviation occurrence was increasingly measured. Conclusion : Based on the results of the study there were differences between value acquired based on theoretical model and actual value. Therefore in respiratory gated radiotherapy using external surrogates, there needs to be establishment of respiration gated radiation system that avoids the combination of two Sorting methods considering that there will be occurrence of treatment and corresponding clinical differences due to the phase difference that occur due to the Amplitude based Phase Sorting.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.65-77
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• 1999

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

• Journal of Korean Tunnelling and Underground Space Association
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• v.19 no.4
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• pp.669-683
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• 2017

The objective of this study is to propose a modification of the previously proposed drainage system for catching the partial leakage of underground concrete structures. Two techniques were proposed for applying the drainage system only to the leaking parts. One was for conveying leaking groundwater to the collection point in the drainage system and the other was for conveying the collected groundwater to the primary drainage system of the underground concrete structure. Four waterproofing materials for conveying leaking groundwater to the catchment point of the drainage system, Durkflex made of porous rubber material, KE-45 silicone adhesive with super strong adhesion, Hotty-gel made of polymeric materials and general silicone adhesive were evaluated for waterproofing performance. Hotty-gel only showed perfect waterproof performance and the other three waterproof materials leaked. The modified drainage system with Hotty-gel and drainage pipe with fixed saddle to convey the leaking groundwater from the catchment point to the primary drainage system were tested on the concrete retaining wall. The waterproof performance and the drainage performance were evaluated by injecting 1,000 ml of water in the back of the modified drainage system at the 7-day, 14-day, 21-day, 28-day, 2-month and 3-month. There was no problem in waterproof performance and drainage performance of the modified drainage system during 3 months. In order to evaluate the construction period and construction cost of the modified drainage system, it was compared with the existing leaching repair method in surface cleaning stage, leakage treatment stage, and protective barrier stage. Total construction period and construction cost were compared in considering the contents of work, repair material, construction equipment, working time, and total number of workers. As a result of comparing and analyzing in each construction stage, it was concluded that the modified drainage system could save construction period and construction cost compared to the existing leaching repair method.