방사선사(放射線士) 교육(敎育)의 임상실습(臨床實習) 개선(改善)에 관(關)한 연구(硏究)

이만구,강세식,윤한식,허준,Lee, Man-Koo,Kang, Se-Sik,Yoon, Han-Sik,Huh, Joon 대한방사선과학회 1983 방사선기술과학 Vol.6 No.1

This study, in order to improve clinical and practical trainings in the education of radiologic technologists, applies to 76 medical institutions of 91 ones which are used as the hospitals of clinical and practical training in 9 existing junior colleges except 3 new ones of 12 ones throughout all over the country from November 1, in 1982 to April 30, in 1983. And the purpose of this study is to research the percent conditions of basic practical trainings and clinical ones enforced in each college, and the percent conditions, equipments, contents, and opinions in clinical and practical trainings enforced in each hospital. The results are summarized as follows; 1. In the case of junior colleges in the whole country the curriculum of basic practical trainings averages 336.66 hours and the limits are between 120 and 510 hours. The actual hours in practice average 140 hours and the limits are between 60 and 240 hours, which correspond to 41.58% of the curriculum of basic practical trainings. 2. There were three junior colleges among nine that had a reserved hospital for clinical and practical trainings(only 33.33%). 3. The period of the practice was almost vacation in 4 junior colleges. The practice was conducted only for students to want the practice(44.45%), junior colleges that all students in them conducted the practice was 2 junior colleges and presented 22.22%. 4. In the field of students engaging in the practice, each field of radiation therapy and nuclear medicine presented 16.5%, 20.3% and almost students didin't have experience for the practice. 5. In medical institutions the educational institutions for intern showed 67.11%. Hospital with radiologist showed 26.32%. Radiotechnologist who had experience below 5 years presented 60.17%. 6. In the equipment for radiation diagnosis, each hospital had no difference. The number of hospitals passessing diagnostic equipments above 125 KVP was 56.26%. But radiation therapy equipment and nuclear medicine equipment had extremely low rate. 7. In the diagnosis of patient in the practice hospital, conventional radiography-to Skull, Chest, Abdomen, Skeleton, Urogenital system-reached the criterion. But special radiography was comparatively low. There appeared low rate, 32.89% in the field of nuclear medicine, 15.79% in the field of radiation therapy. 8. Students who carried out the practice were 1-89 students, days in practice were 1-30 days. There were differences in that point among among hospitals. Junior colleges conducting the practice were 2 colleges per hospital. Scope of the object were 1-8 junior colleges. 9. The practice conducted for the request of the colleges presented 72.37%, in addition, The prctices were conducted for growth of the younger generation and the same coperation with the colleges establishment of sisterhood with the colleges, relationship with students. 10. The practice conducted without the establishment of plan presented 59.21% The need for guiding book to the practice and evaluating was recognized over 90%. 11. In the relation between the practice with achievement of credit. There were big differences in opinion between hospitals-Group and the colleges-Group; hospital-Group had opinion that must follow achievement of credit with the practice. The colleges-Group had opinion that must conduct the practice after achieving credit. 12. After conducting the practice, in the practice leaders satisfaction degree dissatisfactory opinion presented the most rate 80.26%. Very much satisfactory opinion, as one hospital, presentd only 1.32%. 13. Both hospitals-Group and the colleges-Group had an opinion that the practice leader must have actual experiences, lectures and achievement, an opinion that actual experiences is over 5 years. 14. In the guide of human relation, cooperation, responsibility, courtesy to patients. Both hospitals-Group and the colleges-Group had an opinion that the guide must be involved in the period of the practice and must be instructed.

전문대학(專門大學) 방사선과(放射線科) 교육과정(敎育課程)의 수정개발(修正開發) 연구(硏究)

이만구,최종학,Lee, Man-Koo,Choi, Jong-Hak 대한방사선과학회 1988 방사선기술과학 Vol.11 No.1

The purpose of this study is to analyze the problems of the Current Curriculum of Radiologic Technology Department in Junior College, try to find a future solution of the education of Radiologic Technology and a reform measure, and suggest a new substantial model. So this study refered to sundary records, posed a question by papers, made a reform measure of curriculum on the basis of the results, examined it throughly by discussion with the related professors and the industrials figures, and decided a new model. The characteristics of the reform measure reflected in the new model are as follows; 1. It increased the numbers of credits like 94 or 95 ones, to positively accept a developing medical technique and modern science. 2. It set up various general studies and offered a free selection. 3. It closely related majors and their credits to the national examination of lisence and the task of industrial job site. 4. It kept the balance between the periods of lecture, practice, training and their credits. 5, It reinforced the subjects of fundamental medical science such as Introduction to Medicine, Pathology, Biochemistry, Patient Care, etc. 6. It newly established Clinical Trainings as a regular education course. 7. It newly established Introduction to Computer Science, Ultrasonography and Magenetic Resonance Imaging, to cope with the development of the future medical technique. 8. It newly established Humanism in Medicine as a regular education course. 9. It changed the names of subjects resonably.

Compton Scatter Distribution Function in Non-uniform Attenuation Media in SPECT

이만구,Lee, Man-Koo Korean Society of Radiological Science 1991 방사선기술과학 Vol.14 No.2

SPECT 영상에서 콤프톤 산란 광자는 공간분해능의 감소와 그 양을 측정하는데 있어 정확성과 정밀성을 감소시킨다. 이와같은 콤프톤 산란의 영향을 감소시키기 위하여 사용하는 대부분의 보정방법은 선원의 위치로부터 거리의 단일지수함수로 대칭인 산란분포함수를 고려하게 된다. 본 연구는 균등 및 불균등 산란에 대한 산란분포함수를 얻기 위하여 보다 현실적인 접근방법을 시도하였다. 산란 및 비산란광자의 공간분포와 에너지분포를 얻기 위하여 뼈, 폐, 물의 균등 및 불균등 분포로 된 원통형의 팬톰 속에 $^{99m}Tc$의 선선원 및 점선원을 놓고 Monte Carlo Simulation을 하였으며, 깊이의 함수, media의 접촉영역으로부터 선원거리 및 산란체의 밀도의 변화로 표현한 산란분포함수(SDF)를 얻었다. 산란분포함수는 균등한 뼈, 폐, 물에서는 선원위치로부터 거리의 단일지수함수(single exponential functions)로 대칭으로 나타났으며, 두 물체의 조합에서는 2중지수함수(dual exponential functions)로 비대칭으로 나타났다. 산란분율은 20% window photopeak에서 총 계수의 8%에서 53%까지 다양한 변화가 있었으며, 지수함수의 기울기는 $0.1{\sim}0.9\;cm^{-1}$의 범위로 나타났다. 불균등 산란체에서 얻은 산란분포함수는 SPECT 영상에 있어 콤프톤 산란의 감소에 대한 보다 정확한 보정방법의 개발에 필요한 정보를 제공할 것이다.

CT검사건수 및 CT검사에 의한 집단 실효선량의 추정

이만구(Man-Koo Lee),임청환(Cheong-Hwan Lim) 대한방사선과학회(구 대한방사선기술학회) 2010 방사선기술과학 Vol.33 No.3

CT장치는 많은 발전과 임상적 유용성이 향상되고, 의료영상 진단 장치로 중요성을 확립하였다. 그러나 이용률과 보급률이 더욱 증가되고 있는 실정에서 CT에 의한 진단은 환자의 피폭선량이 비교적 높은 검사이기 때문에 이 점에 있어서도 관심이 증가하고 있다. 이에 본 연구에서는 이용량이 계속 증가될 것이므로 이에 따른 방사선 피폭도 증가할 것으로 예상되므로 우리나라에서 시행되는 CT검사건수 및 CT 검사에 의한 집단 실효선량을 추정하고자 한다. DLP(총 선량의 측정값)는 의료기관에서 사용하고 있는 장비의 각각의 검사 영상에 대하여 평균의 선량을 적용하고 계산하여 조사하였으며, CT검사건수는 의료보험심사평가원의 2008년도 발표 자료를 참고로 하여 의료기관 종별로 3년간 검사 통계를 EUR 16262에서 제시된 부위에 준하여 조사하 였다. CT장비의 도입규제 완화정책으로 2010년 3월 말 현재 국내에서 총 1,825대를 보유하고 있고, 인구 백 만명 당 36.8대이다. 의료기관별 CT장치의 설치비율이 의원급에서는 570대로 2.1 %, 병원급에서 52.5 %의 기관이 보유하고 있다. 종합전문요양기관은 기관 당 장치가 3.84대이며, 종합병원은 1.44대를 보유하고 있 다. 1996년 건강보험급여가 실시된 이후 CT진료비 청구건수와 진료비용은 10년(2006) 만에 5배에 가깝게 급증하고 있다. 2007년 전국에서 실시한 CT검사건수는 329만 건이었다. 인구 천 명당 검사건수는 68건이었다. 부위별 검사건수는 복부와 골반검사가 가장 많았다. 집계결과를 2007년도 통계청 우리나라 총 인구는 48,456,000명을 이용하여 연간으로 추계한 총 집단실효선량을 나누어 구한 국민 1인 당 선량은 0.952 mSv로 추정되었다. CT검사는 앞으로도 증가가 예상되며, 투시 등 응용도 확대될 것으로 생각된다. 그러나 한편으로 장치의 발전도 눈부실 것이며, 환자 각자의 체격에 따라 자동적으로 가장 적합한 검사조건을 선택할 수 있는 장치가 개발되어 피폭의 최적화가 기대된다. Computed tomography (CT) has been established as an important diagnostic tool in clinical medicine and has become a major source of medical exposure. A nationwide survey regarding CT examinations was carried out in 2007. Thanks to the appeasement policy regulating the import of CT scanners, there are 1,825 CT scanners across the country as of the end of March 2010, which means that we have 36.8 CT scanners per one million people. The annual number of examinations was 3.29 million, the number of examinations per 1000 population was 68. The most part of examinations was abdomen and pelvis. and the collective effective dose was in these parts. The effective dose per one population was evaluated as 0.952 mSv.

초음파검사에 의한 알코올성 간질환의 위험요인 분석

이만구(Man-Koo Lee),한남숙(Nam-Sook Han),임청환(Cheong-Hwan Lim),정홍량(Hong-Ryang Jung),조정근(Jung-Keun Cho) 한국콘텐츠학회 2009 한국콘텐츠학회논문지 Vol.9 No.3

본 연구는 2007년 3월부터 5월까지 경기도 광주시에 소재하고 있는 K영상의학과의원에서 간 초음파검사에 의한 알코올성 간질환의 위험요인을 분석하기 위하여, 연령, 성별, 음주빈도, 체질량지수, 콜레스테롤 및 GPT 등 6개의 요인을 선정하였다. 연구대상은 20세 이상 69세 미만의 353명을 대상으로 간 초음파검사에 의한 간질환과 음주양태 등과 생활습관의 관계를 분석하였다. 분석 결과 간질환에 걸릴 확률은 남성이 여성보다 2.12배 정도 높은 것으로 나타났으며, 주 3회 이상술을 마시는 사람이 간질환에 걸릴 확률은 주 2회 이하로 마시거나 술을 전혀 마시지 않는 사람들에 비해 약 2.37배 높은 것으로 나타났다. 정상 체질량지수인 사람이 비정상 체질량지수인 사람보다 간질환에 걸릴 확률이 0.52배로 낮은 것으로 나타났다. 콜레스테롤 수치가 비정상인이 간질환에 걸릴 확률이 정상인보다 약 9.13배 정도 높은 것으로 나타났다. GPT 수치가 비정상인 사람은 정상인보다 간질환에 걸릴 확률이 약 4.66배 높은 것으로 나타났다. 따라서 본 연구 결과 간질환을 진단하기 위하여 건강증진 프로그램에 간 초음파검사가 필수적이라고 사료된다. This research attempted to find risk factors of alcoholic liver diseases by ultrasonography at the K image medicine clinic center located in Kwangju city, Kyunggi-Do from March to May, 2007. Six risk factors were selected for this study, age, sex, frequency of alcohol drinking, body mass index(BMI), cholesterol and GPT. The data collected from 353 patients of aged between 20 and 69. This study found the relationships between liver diseases and alcohol drinking style by liver ultrasonography. The results of the analyses showed that the male were 2.12 times more likely to have liver diseases than the female. The persons drinking alcohol more than 3 times per week had 2.37 times higher likelihood of showing liver diseases than below 2 times per week or non drinking at all.. The persons with normal body mass index have 0.52 times lower probability of liver diseases than the persons with abnormal BMI. The persons with abnormal cholesterol level have 9.13 times higher probability of liver diseases. The persons with abnormal GPT have 4.66 times higher probability of liver diseases. The results of this study suggested applying ultrasonography in health promotion programs for diagnosis of liver diseases.

흉부단층촬영시(胸部斷層撮影時) 피폭선량(被曝線量)의 저감(低減)에 관(關)한 연구(硏究)

반야유,이만구,임태랑,석전유치,전전미향,앵정달야,박영희,김창남,신동식,Lino, Yu,Lee, Man-Koo,Hayashi, Taro,Ishida, Yuji,Maeda, Mika,Sakurai, Tatsuya,Park, Yong-Hee,Kim, Chang-Nam,Shin, Tong-Sik 대한방사선과학회 1994 방사선기술과학 Vol.17 No.2

Tomographic examination requires several times of exposure usually, therefore, reduction of radiation dose per exposure without loss of image quality proves of great benefit to patient. We compared the exposure doses under the following experimental conditions, A and B. A is the combination of SRO 380(rare earth screen) and SRH(high contrast film) with additional Cu filters or without. B is the widely used combination which is BH-III and Cronex-4 without additional filter. As a result, comparing with the condition B, the condition A with additional filter of Cu 0.15 mm + Al 0.7 mm, Cu 0.4 mm+ Al 0.4 mm and Cu 0.8 mm showed better Image quality and lower surface dose, 44 %, 31 % and 24 % of the condition B, respectively.

초음파검사에서 여성 골반내 질환별 발생빈도 조사연구

한남숙(Nam-Sook Han),이만구(Man-Koo Lee),임청환(Cheong-Hwan Lim),정홍량(Hong-Ryang Jung),조정근(Jung-Keun Cho) 대한방사선과학회(구 대한방사선기술학회) 2007 방사선기술과학 Vol.30 No.3

  본 연구는 초음파검사를 이용하여 여성 골반내 질환의 발생빈도를 조사하였으며, 기초자료를 제공하기 위한 목적으로 수행되었다. S시에 있는 산부인과 병원에서 1년간에 골반강 초음파검사를 받은 25세 이상 69세 미만의 전체 여성 수검자 604명을 대상으로 하였다. 여성 골반내 질환은 자궁의 혹, 자궁내막 질환, 난소의 혹 및 경부낭종 등 4개 군으로 구분 조사하였고, 연구한 결과는 다음과 같이 나타났다. 위험요인으로 연령, 체중, 임신 횟수의 세 가지를 설정하였다.<BR>  분석 및 결론은 다음과 같다.<BR>  1) 연령별 발생빈도는 출산 연령층(25~35세)에서 10.8%, 출산이 끝난 후 연령층부터 폐경 전 연령층(35~54세)까지에서 38.9%, 폐경 후 연령층(55~69세)에서 35.8%로, 출산이 끝난 후 연령층에서 폐경 전 연령층과 폐경 후 연령층에서 출산 연령층보다 발생빈도가 높게 나타났다.<BR>  2) 여성 골반내 질환의 발생빈도는 체중과 임신 횟수가 증가함에 따라서 증가하였다.   This study was performed for the purpose of providing basic data of the pelvic disorders through survey of the frequency of management of occurrence by major risk factor. Female pelvic mass was detected using sonography, and necessary data were collected from 604 female visitors to a obstetrics and gynecology hospital located at S-si. Female pelvic mass was uterus mass, ovarian mass, cervical cyst, endometrial disease. For the analysis, such variables as age, weight and frequency of pregnancy were chosen as risk factors.<BR>  Results of the analysis and conclusions are as follows ;<BR>  1) The frequency of occurrence of the female pelvic mass is highest, as 38.9% of the component ratio, in the age of 35 to 54. It maintains high level of 35.8% even in the age of 55 and above.<BR>  2) The frequency of occurrence of the female pelvic mass increases in proportion as the weight and frequency of pregnancy increase.<BR>  3) The size of the uterus tumor has no statistical relationship with the risk factors, age, weight and frequency of pregnancy.

방사선사의 개인적 요인이 직무스트레스원에 영향을 주는 관련성 분석

정홍량(Hong-Ryang Jung),김정구(Jeong-Koo Kim),임청환(Cheong-Hwan Lim),김명수(Myeong-Soo Kim),권대철(Dae-Cheol Kwon),이만구(Man-Koo Lee) 대한방사선과학회(구 대한방사선기술학회) 2005 방사선기술과학 Vol.28 No.1

This study is aimed at analyzing the relationship between personal factors of radiological technologists and their job stressors. For this aim, a survey was conducted by means of 890 questionnaires from the middle of July to the end of August 2003 to the subjects of radiological technologists who are working for 44 general hospitals in 16 cities and provinces across the country. The results of the survey could be summed up as follows: 1. The biggest stressor that affects a radiological technologist personally under the working situation turned out to be position, job satisfaction and physical symptom(p<0.001), while job satisfaction and physical symptom also played an important role in personal relationship(p<0.001). 2. In terms of job conflicts, colleagues, immediate seniors, job satisfaction and physical symptoms appeared to exercise great impact(p<0.001), As for job autonomy, age, position and job satisfaction were known to be heavily influential(p<0.001). 3. With regard to job load, job satisfaction and behavioral symptom turned out to have great influence while, in job stability, position and job satisfaction seemed to be immensely influential (p<0.001). The present study has a limit in that it covers only radiological technologists who are working at the 3rd reference hospitals but excludes those who are working at the first and second reference hospitals. The findings, however, are surely believed to be able to serve as basic data to improve the medical service quality as they will help reduce the stressors of and enhance mental and physical health for radiological technologists who play important roles as teammates with expertise in the medical field. These outcomes could also be referred to in future studies in this area. 전국 16개 시도의 44개 3차 의료기관에 근무하는 방사선사의 직무환경에서 발생되는 스트레스원과 개인적인 관련요인을 분석한 결과는 다음과 같다. 근무환경에서 스트레스원에 영향을 주는 개인적인 관련요인은 직위, 직무만족도, 신체화 증상이고, 역할관련에서는 직무만족도와, 신체적 증상이며, 직무안정성에 있어서는 직위와 직무만족도가 많은 영향을 주는 요인으로 나타났다. 직무자율성에서 영향을 주는 요인은 연령, 직위, 직무만족도이고, 직무부담에서는 직무만족도, 행동적 증상이며, 직무갈등에서는 직장동료, 직속상관, 직무만족도, 신체적 증상이 영향을 많이 주고 있는 것으로 나타났다.

Non Breathe Hold Technique를 이용한 MR 담도계조영술에 대한 고찰 : Prospective Acquisition Correction(PACE)기법과 Respiration Trigger Gating(RTG) 기법의 비교

구은희,정홍량,임청환,권대철,조정근,이만구,Goo, Eun-Hee,Jeong, Hong-Ryang,Im, Cheong-Hwan,Kweon, Dae-Cheol,Jo, Jeong-Keun,Lee, Man-Koo 대한디지털의료영상학회 2008 대한디지털의료영상학회논문지 Vol.10 No.1

Recently, MR Cholangiography used mainly bu controlling of patient's breathing. There is breathing hold techniques to get images within shopt time and gating technique adjusted to respiration cycle for high resolution image. In this study, the aim of this experiment is to know on clinical usefulness compared with PACE and RTG thchniques. This study's period is from 2006 in November to 2007 in January. A total of 21 patients investigated at MAGNETOM Sonata 1.5T (SIEMENS Erlangen) with use of 12ch body coil. MR acquisition protocol used 3D turbo spin echo coronal sequence. Scan parameters applied to potimal setting in use as gating techniques, respectively. Analysis of consuming timing evaluated with rapidness. As analysis of quantity, the common bile duct, gall bladder measured in signal intensities, then these data were calculated by signal to noise ratio and contrast to noise ratio. Qualitative analysis, experienced 2radiologists and 3 RTs were evaluated into 3groups about artifact, accuracy of lesions, sharpness of the common bile duct or gall bladder. As a result of analysis, when compared to PACE, consuming time of the RTG took less than PACE, On both CNRs and SNRs, PACE technique was slightly high values than RTG(p<0.05). Qualitative analysis' results, discrimination of lesions in the common bile duct, gall bladder get a significance level in both RTG and PACE techniques but presence's artifact of breathing and pulsation highly demonstrate in PACE techniques. In conclusion, both PACE and RTG methods at MRCP provided prominently clinical information for the common bile duct, gall bladder. If machines have not limitation with performance, induction of breathing holding also will help getting diagnistic quality.

흉부X선촬영시(胸部X線撮影時) 산란선(散亂線)이 화질(畵質)과 피폭선량(被曝線量)에 미치는 영향(影響)

반야유,임태랑,석전유치,전전미향,앵정달야,이만구,안봉선,김정민,Iino, Yu,Hayashi, Taro,Ishida, Yuji,Maeda, Mika,Sakurai, Tatsua,Lee, Man-Koo,An, Bong-Sun,Kim, Jung-Min 대한방사선과학회 1993 방사선기술과학 Vol.16 No.2

To investigate relationships between image guality and exposure dose, Chest X-ray films were evaluated for the following points:how much scattered radiation can affect reduction in image quality and can be permissible diagnostically? For this purpose using a test charts and Burger's phantoms. The visual evaluation of their X-ray films and the measurements of scattered radiation were carried out. The dose of scattered radiation ranging from 20 to 25% was found to be for nothing in any diagnostic obstacle. In this range, surface doses were low of 17, 21, and $25{\mu}Gy$ for The thickness of the chest of 15, 20 and 25 cm respectively. Comparison of these high voltage X-ray films with low voltage ones showed a surface dose rate of 1:11.7. Therefore, X-ray quality, photosensitive materials(film and screen) and grid should be selected very carefully for the purpose of reduction in exposure dose.