제 10 회 한문교육과 학술답사보고서

이종식 근역한문학회 1984 漢文學論集 Vol.2 No.-

노인 만성질환자의 건강관리를 위한 원격의료모니터링의 효용성 연구

이종식 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.6

Now, the world, including Korea, is facing severe economic downturn and limited economic activity, both nationally and personally, due to the Corona 19 Pandemic crisis. As the environment of social communication changes as the society moves toward an untact society, many changes are expected throughout society. At the center of the change is in-depth research on telemedicine and telemedicine monitoring. However, there have been many problems with telemedicine, where there are many side effects caused by the exposure of personal information during implementation, and misdiagnosis due to carelessness in patient measurement and error in the remote medical system. These various problems have led to legal difficulties in telemedicine between patients and medical staff. However, as the situation of Corona 19 continues, telemedicine monitoring for elderly people with chronic diseases in the medical blind spot is drawing attention. Therefore, in this study, non-face-to-face health care services, especially for chronic diseases of the elderly patients with chronic diseases, were studied with parsona techniques through experiments to see if telemedicine monitoring was useful for health care. As a result, patients with chronic diseases expressed satisfaction with their high interest and participation in telemedicine, but it was difficult to proceed smoothly due to poor communication. Therefore, telemedicine will require a variety of high-quality devices for measurement and will be able to operate safely only when a system is established to ensure that there is no misdiagnosis by bringing the patient's health information accurately.

코로나 팬더믹 사태(COVID-19)에서 원격의료 활성화 방안에 관한 연구

이종식 한국지식정보기술학회 2020 한국지식정보기술학회 논문지 Vol.15 No.5

최근 코로나19 팬데믹으로 ‘사회적 거리 두기’ 확산에 따라,‘언택트(untact) 소비’가 일상화되면서 ‘언택트 사회’는 새로운 패러다임으로 등장했다. 언택트 서비스에 대한 소비자 인식조사 결과, 포스트 코로나19 비대면 소비 비중은 코로나19 이전보다 1.6배 증가할 것으로 예상되며, 원격의료 (24.7%) 관련 산업의 중점 육성이 필요한 것으로 나타났다. 우리는 현재 코로나19 팬더믹 상황으로 일반적인 대면진료의 제약을 받고 있고 포괄적인 차원에서 원격의료 진료의 도입의 검토가 필요한 상태이다. 하지만 원격의료를 추진함에 있어서 개인정보보호법 등의 법적인 보호가 필요한 상태이다. 원격의료의 특성상 개인 의료정보의 분실, 도난, 유출, 변조 또는 훼손을 방지하기 위한 최고 수준의 정보보안 수준을 갖춘 시스템을 도입, 구축해야 할 것이고, 의료법에 개인정보보호 관련 법령을 명시할 필요가 있다. 또한 원격의료는 현행 의료법의 원칙인 대면진료와 달리 촉진, 청진, 타진 등의 진료방법이 배제되므로 진료 결과의 안정성을 완전히 담보할 수는 없다. 원격의료기기의 문제와 통신 장애로 인한 오진에 대한 책임에 대한 법적인 귀속의 문제와 지역의 대형병원의 의료인과 소형병원의 의료인간의 문제와 환자의 양질의 의료 서비스 차원과 개인정보 보호법에 대한 문제와 정부의 입장에서 적절한 사회적 협의를 통한 노력이 필요한 상태이다. 지금 정부가 한시적으로 원격의료를 추진하고 있지만 개인정보 보호법과 귀속문제 등의 법적인 문제와 의료인과 의료인간의 문제와 환자의 입장에서 논의하여 협의가 필요한 상태이다. 이러한 문제가 선결된 후에 원격의료를 좀 더 활성화하여 현재의 코로나19 패더믹 상태에서 환자들에게 원격의료가 대면진료의 보완적 차원에서 역할을 할 수 있도록 검토가 필요하며 향후 정보통신 및 의학기술의 발전에 맞추어 단계적인 입법을 통하여 원격의료의 환자와 의사간의 실효성 있는 시스템으로 보완 완성해 나가야 할 것이다.

F-29 비결핵항산균 폐질환 치료 중 확인된 균종 교체의 임상적 의미

이종식,이종혁,윤순호,한성구,임재준 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.-

목적: 비결핵항산균 폐질환을 치료하는 중 다른 종류의 비결핵항산균이 지속적으로 검출되는 경우가 있다. 이 연구의 목적은 비결핵항산균 폐질환 치료 중 확인된 균종 교체의 임상적 의미를 확인하는 것이다. 방법: 2009년 1월1일부터 2015년 12월 31일 사이에 서울대학교병원에서 비결핵항산균 폐질환으로 진단받고 치료를 시작한 환자 중 다른 종류의 비결핵항산균으로 교체된 환자의 임상적 특성과 교체 전후의 증상 및 영상 소견의 변화를 분석하였다. 성적: 연구 기간 동안 비결핵항산균 폐질환으로 진단받은 환자는 모두 473명이었으며, 이 중 164명이 치료를 시작하였다. 이들 중 16명(9.8%)에서 치료 도중 다른 종류의 비결핵항산균으로 교체되었다. 이들의 나이의 중앙값은 67세 (IQR: 59.5~72.5)였고, 남녀비는 1:7 이었다. 원래의 폐질환은 M. avium complex 폐질환과 (10명) M. abscessus complex 폐질환(6명)이었다. M. avium comlpex에서 M. ab-scessus complex로 균종이 교체되는 경우가 모두 8명에서 관찰되어 가장 흔했다. 16명 중 8명의 환자가 균종 교체와 함께 호흡기 증상이 악화되었으며, 7명의 환자의 영상 소견이 악화되었다. 이를 종합하여 5명의 환자에서 교체된 균종에 의한 비결핵항산균 폐질환이 새로 발생한 것으로 확인되었다. 결론: 치료 도중 비결핵항산균의 교체는 새로운 균종에 의한 폐질환 발생을 의미할 수 있어 주의깊은 관찰이 필요하다.

가상현실 기기를 활용한 고령자 사용자 경험에 관한 연구

이종식,이강년 한국지식정보기술학회 2018 한국지식정보기술학회 논문지 Vol.13 No.3

This study is about the elderly people's use and experience of Virtual Reality (VR) in order to enhance their quality of life. Leisure is main activity of the elderly. As a result, the quality and diversity of leisure affects the quality of the elderly people's life. VR services including video contents could provide them with advanced and interesting experiences. Across the world, population aging becomes one of the most important problems in each society. The social and economic burden of aging is serious challenge to sustainability welfare of the world, including S. Korea. The authors used virtual reality devices to conduct experiments on 99 aged 50 to 90 (men's average age : 75 and women's average age : 70.8). Through the survey, major variants were measured such as system quality, present sense, enjoyment, intent to reuse, and awareness of advanced technology. Multiple regression analyses with the presence as a dependent variable resulted in a sense of closeness (t = 5.381, p <. 01) and a sense of clarity (t = 4.494, p <. 01). The presence of an independent variant had significant effects on pleasure (t = 4.312, p <. 01) and significant effects on the intent to reuse (t = 3.323,).Therefore, it can be interpreted that the higher the sense of existence, the more pleasure and the intent to reuse it. As a result, the possibility of using VR devices and content to enjoy leisure activities can be found in this study even if the elderly group is unfamiliar with IT devices.

고령자 만성질환 및 건강관리 모니터링에 관한 연구: 웨어러블 기기의 효과

이종식,이강년 한국지식정보기술학회 2018 한국지식정보기술학회 논문지 Vol.13 No.3

This study is on the elderly people's use and experience of a wearable device. By using wearable device, the elderly can monitor their health data at real time. As a result, their motivation for health care, exercise, and so on can improve and enhance. Across the globe, population aging becomes one of the most important problems in each nation. The social and economic burden from aging is one of most serious challenges to sustainability of the world and its economy, including South Korea. Information Communication Technology including wearable device can help the elderly health care improve. In 2016, the number of wearable devices is more than 19 million. Many of them are the devices related to health data monitoring. In the experiment, the authors measure real time health data from the subjects' wearable devices. In the first experiment day, subjects' average waist size was 36.29 inches. In the final experiment day, 31st day later from start of the experiment, the average waist size was 35.51 inches. At the beginning of the experiment, standard deviation was 1.93. At the final day of the experiment, it was 2.24. In regression analysis, when experiment day extends, average waist size seems to decrease. The trend is significant (t=2.719, p<0.05). That result may mean the subjects' motivation for health care improve. Wearable device can increase the elderly people's motivation for health care and exercise. As a result, their health can improve.

반려동물형 로봇을 이용한 고령자 심리 안정의 향상 방안

이종식,이강년 한국지식정보기술학회 2018 한국지식정보기술학회 논문지 Vol.13 No.3

This study is on the elderly people's use and experience of pet robots (companion robots). Applying companion robots for the elderly's daily lives can enhance their quality of life. Leisure is main activity of the elderly who are out of work. Therefore, the quality and diversity of leisure can affect the quality of their life. Companion Robots could provide them with more advanced and interesting experiences. Around the world, population aging becomes one of the most important trends in each country. The social and economic burden of aging is serious challenge on sustainability of the world, including S. Korea. The authors examine use of Companion Robots for elderly (from 50 years old to 90 years old). In this experiment, the authors study and measure many factors including system quality, interface quality, displeasure, enjoyment, willingness to reuse, perception on new technology. In regression analysis, intimacy(t=-2.006, p<.05) is significant factor on displeasure of Companion Robot. In another regression, displeasure of Companion Robot (independent variable) is significant factor on enjoyment(t=-3.327, p<.01) and willingness to reuse(t=-2.636, p<.01). Therefore, when elderly one feels less displeasure of Companion Robot, he/she feels more enjoyment and willingness to reuse. As a result, the elderly who don't familiar to new technology could improve quality of life and leisure activity by using companion robot.

고령화에 따른 도시형 노인 시니어 멀티 케어존 실효성에 관한연구

이종식 한국지식정보기술학회 2018 한국지식정보기술학회 논문지 Vol.13 No.2

Korean government has taken various population policy so far According to demographic results, The aging population is rapidly aging and it is expected to deepen in the future. However, many senior citizens are also exposed to poor economic conditions and inconsistent health care risks Most seniors suffer from mental illness and chronic diseases. seniors in traditional cities feel very alienated as they change from large family to small family. As the number of elderly people living alone grows, social problems increase. At present, the health care for the elderly who live alone is not being taken properly, and they are under a very poor management system, both physically and mentally. Every human being has to be old, and we aim to spend our old age processes physically and mentally healthy. As the basic age of the elderly increases, it is necessary to consider various aspects of the welfare policies and medical policies that are followed. In this study, 100 elderly people over the age of 65 were surveyed for economic situations and physical and mental health conditions, and specially performed study on utility of 'urban senior multi care zone' to prove the necessity of introducing the latest digital devices to resolve these problems more effectively by analyzing serious feelings of alienation, loneliness, and emotional situations. Lastly, We conducted this research to find ways to help the elderly through customized health care.

개인정보 유출로 인한 소비자 피해의 보상 및 분쟁 해결에 관하여 - 정신적 피해보상 중심으로 -

이종식 한국지식정보기술학회 2018 한국지식정보기술학회 논문지 Vol.13 No.1

All cases of compensation and dispute resolution involve some form of emotional difficulty. Even when material compensation is made, it is hard to say that it makes up for non-pecuniary losses, that is, emotional distress. Then is it currently possible to be compensated for emotional distress in all legal disputes? Although possible in some cases, it is not easy to claim damages for emotional distress since the action of the defendant has to be shocking and extreme, and concrete enough to prove that the defendant’s deliberate and reckless action caused emotional distress. There must also be factual evidence such as receiving medical treatment as a result of the defendant’s action, as well as a causal relationship between the defendant’s action and the consumer’s damage. Therefore, it is difficult to claim damages for emotional distress, and only a few cases which satisfy all the above conditions have received compensation. The current Consumer Protection Law stipulates 1) the right to safety 2) the right to be informed 3) the right to choose 4) the right to be heard 5) the right to redress 6) the right to consumer education 7) the right to organize 8) the right to a healthy environment as the basic rights of consumers. This paper focuses on compensation for emotional distress included in 5) the right to redress, and more specifically, the compensation for consumer damage following the leakage of personal information on the Internet. Material compensation is important, but to make a better policy for both consumers and companies, it is also important to analyze the situation in which the victims suffer from emotional distress that takes place in various situations following personal data leakage, and ensure that those victims are provided with better and real compensation.

Efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors for patient with leptomeningeal metastasis of epidermal growth factor receptor mutant non-small cell lung cancer

이종식,이경안,이강훈,문선영,김인애,전성진,민재기,김희정,이계영 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1

We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.