• 의료법학
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• 제24권4호
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• pp.37-63
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• 2023

의료소송에서 의사의 환자에 대한 '설명'이 문제되는 경우는 다양하다. 진단의 초기부터 시작하여 수술 등의 치료과정, 치료를 위해 입원이 필요한 경우, 입원 중과 퇴원 시, 그리고 퇴원 후에 이르기까지 의학적인 설명과 지도가 의사에게 요구된다. 나아가 의료행위로 인하여 발생하게 될 경제적 비용에 대하여도 의사 혹은 의료기관의 고지가 요청되기도 한다. 우리나라 사법부는 이와 같은 의사의 설명에 대하여 진료의 단계 및 의료법 등 관계법령을 고려하여 의료행위에 대한 동의를 구하기 위한 설명과 환자의 요양방법 지도와 관련된 진료상 설명을 구분하여 법리를 전개해 오고 있다. 또한 헌법재판소는 경제적 비용에 관한 설명과 연계된 비급여 비용 고지 제도에 관하여 최근 판단하기도 하였다. 그런데 의사의 설명이 불충분하였다는 것만을 이유로 의사에게 책임을 추궁을 하는 것은 임상현실의 실제 상황과 부합하지 않는 측면이 존재하고, 오히려 의권의 위축을 초래하는 반사적인 불이익이 있을 수 있다. 따라서 의사의 설명은 환자의 자기결정권 보장과 의권 보호라는 양측면에서 살펴보아야 할 필요가 있다.

• Environmental Engineering Research
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• 제23권2호
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• pp.136-142
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• 2018

The river water source of Saidabad Surface Water Treatment Plant at Dhaka, Bangladesh, is deteriorated too much to be treated by conventional treatment process due to excessive ammonia pollution. In order to improve the raw water quality before it enters into the main treatment chain, a pilot study was conducted for pre-treatment of the raw water. The objective is to investigate the rate of reduction of ammonia using the Meteor pilot, a biological pretreatment system, which is a laboratory scale Moving Bed Biofilm Reactor with a nominal volume of hundred liters, filled with 50 L of Meteor 660 media. The reduction of ammonia was quite significant on average 73%, while the reduction of COD was in a range from 20 to 60%. The Meteor pilot was able to treat and nitrify the raw water and produce an effluent that respects the guarantee of ammonia < $4.0mg\;NH_3-N/L$ when the raw water ammonia concentration was < $15mg\;NH_3-N/L$. The study identified operating parameters necessary to achieve the desired goal of adequate ammonia removal. The study results would benefit a range of systems across the country by providing guidance on the design and operation of a biological pre-treatment system for ammonia removal.

• 대한골관절종양학회지
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• 제13권1호
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• pp.14-21
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• 2007

Bone is a common site for metastatic spread from many kinds of malignancies. The morbidity associated with this metastatic spread can be significant, including severe pain. When it comes to spinal metastasis, occupying nearly 40% of skeletal metastases, the risks of complications, such as vertebral body collapse, nerve root impingement, or spinal cord compression, are also significant. Because of the necessity of preserving the integrity of the spinal column and the proximity of critical structures, surgical treatment has limitations when durable local control is desired. Radiotherapy, therefore, is often used as an adjunct treatment or as a sole treatment. A considerable limitation of standard radiotherapy is the reported recurrence rate or ineffective palliation of pain, either clinically or symptomatically. This may be due to limited radiation doses to tumor itself because of the proximity of critical structures. CyberKnife is an image-guided robotic radiosurgical system. The image guidance system includes a kilovoltage X-ray imaging source and amorphous silica detectors. The radiation delivery device is a mobile X-band linear accelerator (6 MV) mounted on a robotic arm. Highly conformal fields and hypofractionated radiotherapy schedules are increasingly being used as a means to achieve biologic dose escalation for body tumors. Therefore, we can give much higher doses to the targeted tumor volume with minimizing doses to the surrounding critical structures, resulting in more effective local control and less severe side effects, compared to conventional fractionated radiotherapy. A description of this technology and a review of clinical applications to bone metastases are detailed herein.

• 전기학회논문지
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• 제59권1호
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• pp.220-224
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• 2010

In this study, we designed a device for consecutively observing position, utilizing 3-axises acceleration sensor. This method offer to check his or her wrong position and developed could to help derived a position appliance. And, we developed a Cobb's angle value in three dimensional using 3-axises acceleration sensor. A proposed device with integrated accelerometers, which can detect postural changes in terms of curvature variation of the spine in the sagittal and coronal planes, has been developed with intention to facilitate posture training. The proposed device was evaluated with 3 normal subjects daily activities. We evaluated the performance of our designed device as calculating the correlation coefficients and mean errors between the angle measured by an electro-goniometer and that estimated by a gravity accelerometer and verified the accuracy and sensitivity. The results showed that the angle obtained from the proposed device revealed a linear characteristic at the range of $\pm60^{\circ}$(correlation coefficient 0.99, error range $\pm2^{\circ}$). We demonstrated that our device could detect the changes of the motion in upper trunk accurately. Also, our device showed good potential for treatment of the patients with scoliosis and prevention of the unbalance position during a daily life.

• 대한환경공학회지
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• 제38권5호
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• pp.249-254
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• 2016

본 연구에서는 상용 유리화설비 설계를 위한 기초자료에 도움이 되고자 용융공정에서 발생되는 배기가스의 특성과 배기가스 처리계통 운영사례를 조사하였다. 유리화설비 운영의 목적은 용융공정으로 투입된 방사성폐기물 내에 함유되어 있는 유해물질과 용융공정 내에서 발생된 다양한 화학종을 함유하고 있는 유해 배기가스를 처리하는 것이다. 유리화설비를 건설, 운영하기 위해서는 안전성 분석을 통한 인허가가 필수적이며, 부산물로 발생하는 방사성핵종이나 유해물질을 법적 환경배출규제치 이하로 처리하는 것이 매우 중요하다. 이를 위해서는 배기가스의 특성을 정확히 파악하여 그 특성에 따라 적절한 배기가스 처리공정을 설계해야 한다. 따라서 적절한 배기가스 처리계통을 설계하는 데는 폐기물 발생 특성, 용융로 특성, 배기가스 규제지침, 배기가스 발생 특성, 배기가스 처리장치에 대한 성능 평가 등의 광범위한 요소를 고려해야 한다.

• Geomechanics and Engineering
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• 제34권2호
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• pp.155-171
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• 2023

Aiming at the grouting treatment of water inflow in karst conduits, a visualized experiment system for conduit-type grouting blocking was developed. Through the improved water supply system and grouting system, and the optimized multisource information monitoring system, the real-time observation of diffusion and deposition of slurry, and the data acquisition of pressure and velocity during the whole process of grouting were realized, which breaks through the problem that the monitoring element is easy to fail due to slurry adhesion in conventional test system. Based on the grouting experiments in static and flowing water, the diffusion and deposition behavior of the quick-setting slurry under different working conditions were analyzed. The temporal and spatial variation behavior of the pressure and velocity were studied, and the blocking mechanism of the grouting were further revealed. The results showed that: (1) Under the flowing water condition, the counter-flow diffusion distance of slurry was negatively correlated with the flow water velocity and the volume ratio of cement and sodium silicate (C-S ratio), and positively correlated with the grouting volume. The slurry deposition thickness was negatively correlated with the flowing water velocity, and positively correlated with the grouting volume and C-S ratio. (2) The pressure increased slowly before blocking of the flowing water and rapidly after blocking in karst conduits. (3) With the continuous progress of grouting, the flowing water velocity decreased slowly first, then significantly, and finally tended to be stable. According to the research results, some engineering recommendations were put forward for the grouting treatment of the conduit-type water inflow disaster, which has been successfully applied in the treatment project of the China Resources Cement (Pingnan) Limestone Mine. This study provided some guidance and reference for the parameter optimization of grouting for the treatment projects of water inflow in karst conduits.

• 한국정보통신학회논문지
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• 제25권2호
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• pp.208-213
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• 2021

컴퓨터 활용을 통한 문화도 기존의 문화 형태를 변화시킬 만큼 다양하고 빠르게 변화되고 있다. 앉아서 생활하는 시간이 증가하면서 인간은 요통의 질병에 더 많이 노출 되었으며, 요통은 허리디스크를 중심으로 허리와 관련된 통증을 포함한다. 요통의 대부분은 척추와 몸통을 지지해주는 근육과 인대 이상에 따른 원인이 크다. 이에 허리 요통을 포함한 건강한 허리를 유지하기 위한 효과적인 대책이 필요하다. 본 논문에서는 요통을 감소하거나 치료에 도움을 줄 수 있도록 요추 운동효과를 얻을 수 있는 앱 개발을 위한 전반적인 설계를 제시한다. 이를 효과적으로 사용하기 위해서 요추 운동효과를 얻기 위한 방안을 제시하고, 이를 그래픽기반 유도점을 활용하여 효과적인 요통 치료에 도움일 될 수 있는 앱 설계 제시를 목표로 한다.

• 대한후두음성언어의학회지
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• 제32권3호
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• pp.118-123
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• 2021

The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

• 치위생과학회지
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• 제20권1호
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• pp.1-8
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• 2020

Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

• 대한관절경학회지
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• 제4권2호
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• pp.138-143
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• 2000

목적 : 관절경 소견을 기준으로 슬관절 대퇴골과의 박리성 골연골염에 대한 치료를 시행하여 그 결과를 임상적 및 방사선학적으로 분석 하였다. 대상 및 방법 : 대퇴골과의 박리성 골연골염 환자 17면 19례에 대해 관절경을 시행하고 그 소견을 토대로 치료방법을 결정하였다. 관절경 관찰후에 특별한 조작을 가하지 않은 경우를 1군, 다발성 천공술을 시행한 경우를 2군, Herbert 나사로 고정을 시도한 경 우를 3군, 유리체 제거나 기저부 소파술을 시행 한 경우를 4군으로 분류하여 그 결과를 Hughston등의 방법에 의한 분석으로 우수, 양호, 보통, 불량, 실패 등으로 분류하였다. 결과 : 총 19례 중 14례$(74\%)$에서 양호 이상의 결과를 얻었다. 치료 방법에 따른 분류상 1군 중 3례(3/4)에서, 2군 중 3례(3/4)에서, 3군 중 7례(7/8)에서, 4군 중 1례(1/3)에서 양호 이상의 결과를 얻었다. Herbert 나사 고정군에서 다른 군보다 더 좋은 결과를 나타냈다. 결론 : 대퇴골과의 박리성 골연골염의 치료 방법 결정에 있어서 관절경 소견은 믿을만 한 지표로 판단되었으며, 이를 토대로 골성장판이 완전 폐쇄되기 전의 환자에서 Herbert 나사 고정술과 같이 병변부에 대하여 적극적인 재건을 시도하여 만족 할 만한 결과를 얻을 수 있었다.