Job Competency in Ultrasonography of Korean Radiological Technologists

임창선(Chang Seon Lim),김축복(Chuk Bok Kim),남궁장순(Jang Sun Namkung),진계환(Gye Hwan Jin) 한국방사선학회 2019 한국방사선학회 논문지 Vol.13 No.6

캐나다 등 많은 국가들이 초음파사(sonographer) 면허제도를 방사선사면허와 별도로 운영하고 있다. 그러나 한국에서는 방사선사가 의사의 지도아래 초음파영상검사를 수행하고 있다. 이에 방사선사의 초음파영상검사에 대한 직무역량을 분석하여 체계적으로 교육할 기회를 갖기 위하여 캐나다 초음파사의 표준직무역량(National Competency Profile)을 토대로 한국에서 방사선사가 초음파영상검사를 수행함에 있어 요구되는 직무역량과 세부역량들에 대한 직무 내용타당도를 측정하였다. 한국 방사선사 직무역량에 포함된 핵심역량의 중요도과 직무수행 정도를 비교분석한 결과 전체 중요도의 평균은 4.087점, 전체 수행도의 평균은 3.640점으로 중요도가 더욱 높았으며, 통계적으로 유의한 차이를 보였다. 그 결과 ‘A 의사소통’, ‘B 전문가적 책임’, ‘D 장비취급’, ‘G 근무 장소의 건강 및 안전’은 직무내용타당도가 높았다. 그러나 ‘C 환자 평가와 돌봄’, ‘E 비평적 사고와 문제해결’, ‘H 영상’은 직무 내용타당도가 낮게 나타나 이들 역량을 강화하고 보완할 수 있는 방안이 모색되어야 한다. Many countries, including Canada, operate a sonographer license system separately from a radiological technologist license. However, in Korea, radiological technologists perform ultrasound imaging under the guidance of doctors. Therefore, in order to have the opportunity to provide a systematic education by analyzing the job competency of the radiological technologist’s ultrasound imaging, based on the Canadian National Competency Profile (NCP) lists, this study measured the job content validity of the job competences and detailed competencies required for performing ultrasonography in Korea. From the results of comparing and analyzing the importance of the core competencies included in the Korean radiological technologist’s job competencies and the degree of job performance, the average overall importance was 4.087, the average of overall performance was 3.640, showing that the importance was higher than the performance and that there was a statistically significant difference. In conclusion, A Communication , B Professional responsibilities , D Operation of equipment and G Workplace health and safety showed high job content validity. However, it is said that as C Patient assessment and care , E Critical thinking and problem solving , and H Image showed low job content validity, it is necessary to seek ways to strengthen and complement these competencies.

유방암의 척추전이로 흉추골절 발생한 하지마비 환자의 한.양방 병용 치험 1례

김성근,임창선,김미영,구범모,양동호,Kim, Sung-Keun,Lim, Chang-Sun,Kim, Mi-Young,Koo, Beam-Mo,Yang, Dong-Ho 척추신경추나의학회 2008 척추신경추나의학회지 Vol.3 No.2

Objective : The purpose of this paper is to report the improvement of the patient with paraplegia after acupuncture, moxibustion, and herbal medicine. Methods : We treated the patient with acupuncture, moxibustion and herbal medication. Results : We treated one case of paraplegia. This patient improved significantly through acupuncture, moxibustion, herbal medicine, and western medicine. Conclusion : Through a collaboration of Western and Korean medicine, we were able to achieve meaningful treatment results.

의인성 쿠싱 증후군과 동란하여 발생한 스테로이드 근병증과 요추 압박 골절 1예

양동호,임창선,김성근,이경윤,신현승,임준혁,Yang, Dong-Ho,Lim, Chang-Sun,Kim, Sung-Keun,Lee, Kyung-Yun,Sin, Hyun-Sueng,Yim, Jun-Hyok 척추신경추나의학회 2009 척추신경추나의학회지 Vol.4 No.2

Objective : The purpose of this study is to report the improvement after the acupuncture therapy and herbal medicine about a patient who has latrogenic Cushing with steroid induced myopathy and compression fracture of L-spine. Methods : We treated the patient with Neutral Blood Stasis herbal acupuncture, acupuncture therapy and herbal medication. Results : We have experienced one case of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine. This case improved significantly through acupuncture and herbal medication treatment. Conclusions : This study suggests manual acupuncture therapy and herbal medication is effective for the improvement of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine.

프로 축구선수의 양도락 분석을 통한 신체특성 연구

허승진,임창선,임준혁,Heo, Seung-Jin,Lim, Chang-Sun,Yim, Jun-Hyok 척추신경추나의학회 2010 척추신경추나의학회지 Vol.5 No.1

Object: This study was planned to show the physical characteristics of soccer player and their Yangdorak measurements. Method: We categorized 5 study group. (I-Players classified by age; II, III-Players and control group; IV-Players who had positive RF and the others; V-Players who had digestive disorder and the others) And We conducted the potentiality of skin resistance(Yangdorak) and GFS, PFT, ECG and the other, then analysis that. Result: As old aged group, Yangdorak shown lower RS, but that was not significant. Player group had higher Yangdorak score at H5, F1, F2, F5 than control group. Player group was shown better cardiopulmonary function, but H1, H2, H3 score were not significant. Players who conducted RF test shown not significant difference of H4 measurement between positive and negative group. Digestive disorder group had higher F1, F6 score, but that wasn't significant.

급성기 뇌경색 환자에서 한방치료와 지속적 유로키나제 정주요법 병용시 안전성에 대한 임상적 고찰

김성근,임창선,임준혁,양동호,신현승,박준하,정승철,Kim, Sung-keun,Lim, Chang-sun,Yim, Jun-hyok,Yang, Dong-ho,Shin, Hyon-seung,Park, Joon-ha,Jeong, Seung-cheol 대한중풍순환신경학회 2009 대한중풍.순환신경학회지 Vol.10 No.1

Objectives : This Study was prepared for investigating the safety of oriental medicine and continuous intravenous urokinase combined therapy in acute cerebral infarction. Methods : We prospectively estimate safety of hemorrhagic transformation occurred in oriental medical therapy and continuous intravenous urokinase combined therapy. We estimate National Institute of Health Stroke Scale Score and Modified Barthel Index. Results : Hemorrhagic transformation was not noted. and Others are not fatal complication. Conclusions : oriental medical therapy and continuous intravenous urokinase combined therapy are safety method in treatment of acute cerebral infarction. We think this can be a good model of Oriental and western cooperative therapy.

미분화된 신체형장애를 향부자팔물탕(香附子八物湯)으로 치료한 소음인(少陰人) 환자(患者) 치험례

김나영,최인호,임창선,신미란,Kim, Na-Young,Choi, In-Ho,Lim, Chang-Sun,Shin, Mi-Ran 사상체질의학회 2008 사상체질의학회지 Vol.20 No.3

1. Objectives Sasang Constitutional Medicine is Mind-Body medicine and it is based on difference of Nature & Emotion(性情) & real purpose(恒心). The purpose of this study is to evaluate the effect of Hyangbujapalmul-tang for somatoform disorders and is to drive the importance of psychiatric approach home. 2. Method The subject is about 49-year-old Soeumin patient presumed by Undifferentiated somatoform disorder based on his nature & emotion, physical characteristics, symptoms, and we have prescribed Soeumin Hyangsayangyui-tang, Ceongunggyegi-tang, Hyangbujapalmul-tang. Soeumin Hyangsayangyui-tang was prescribed based on oridinary symptoms(素症), Soeumin Ceongunggyegi-tang was prescribed based on real symptoms(病症), Soeumin Hyangsayangyui-tang was prescribed based on Nature & Emotion(性情) & real purpose(恒心). 3. Result and conclusions In result, Hyangbujapalmul-tang based on Nature & Emotion(性情) & real purpose(恒心) showed best positive response. It is necessary to approach to somatoform disorders not only in clinical view but also in psychiatric view based on Nature & Emotion(性情) & real purpose(恒心)

급성 파종성 뇌척수염 환자의 치험 2례

구범모,이경윤,양동호,김성근,임창선,박영철,이주일,김주영,Koo, Beom-Mo,Lee, Kyung-Yun,Yang, Dong-Ho,Kim, Sung-Keun,Lim, Chang-Sun,Park, Young-Chul,Yi, Joo-Il,Kim, Joo-Young 대한침구의학회 2008 대한침구의학회지 Vol.25 No.3

Objectives : The purpose of this case is to report the improvement of the patients with Acute Disseminated Encephalomyelitis(ADEM) after acupuncture, moxibustion, and herbal medicine. Methods : We treated the patients with acupuncture, moxibustion and herbal medication. Results : We treated two cases of Acute Disseminated Encephalomyelitis(ADEM). These two patients improved significantly through treatment, acupuncture, moxibustion, herbal medicine, and western medicine. Conclusions : In Acute Disseminated Encephalomyelitis (ADEM), the initial diagnosis is important, and through a collaboration of Western and Korean medicine, we were able to achieve meaningful treatment results.

의인성 쿠싱 증후군과 동반하여 발생한 스테로이드 근병증과 요추 압박 골절 1예

양동호(Yang Dong ho),임창선(Lim chang sun),김성근(Kim Sung keun),이경윤(Lee Kyung yun),신현승(Sin Hyun sueng),임준혁(Yim Jun hyok) 척추신경추나의학회 2009 척추신경추나의학회지 Vol.4 No.2

Objective : The purpose of this study is to report the improvement after the acupuncture therapy and herbal medicine about a patient who has Iatrogenic Cushing with steroid induced myopathy and compression fracture of L-spine. Methods : We treated the patient with Neutral Blood Stasis herbal acupuncture, acupuncture therapy and herbal medication. Results : We have experienced one case of Iatrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine. This case improved significantly through acupuncture and herbal medication treatment. Conclusions : This study suggests manual acupuncture therapy and herbal medication is effective for the improvement of Iatrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine.

핵의학과에서 환경방사선량 측정에 대한 연구

강보선(Kang, Bo-Sun),임창선(Lim, Chang-Seon) 한국산학기술학회 2010 한국산학기술학회논문지 Vol.11 No.6

국내의 경우 방사선작업종사자의 개인피폭관리는 선량한도를 초과한 피폭의 유무를 확인하여 사후 조치를 취하는 것에 초점이 맞추어져 있다. 그러나 의료기관 핵의학과의 경우 개봉선원을 사용하므로 작업환경이 방사선에 노출될 가능성이 많고, 방사성의약품 투여 후 수 시간 혹은 수 일 동안은 환자 자체가 방사선원이 되므로 방사선작업 종사자나 수시출입자, 환자보호자들의 방사선 피폭 가능성이 매우 높다. 따라서 환자보호자 등 일반출입자의 방사선 피폭을 방지하기 위해서는 환경방사선관리가 적절하게 실시되어야 한다. 일본에서는 「방사성동위원소등에 의한 방사 선장해의 방지에 관한 법률」등에 근거하여 방사선작업환경에 대한 환경방사선량을 정기적으로 측정, 보관하도록 하 고 있다. 이에 대전시 소재 대학병원 핵의학과에서 일본에서 시행하고 있는 것과 같은 방법으로 핵의학과 내 8개소에 유리선량계를 설치하여 환경방사선을 측정한 결과 8개소 모두 「진단용 방사선 발생장치의 안전관리에 관한 규칙」 에 규정된 방사선구역의 외부방사선량인 주당 0.3 mSv에는 훨씬 미치지 못하는 적은 선량이 측정되었다. 그러나 접 수대에서는 3개월 누계 선량률이 0.51 mSv로서 접수대 종사자는 일반인 연간 유효선량한도인 1 mSv를 초과할 가능 성이 높았으며, 환자 및 보호자 대기실에서도 0.23 mSv(3개월 누계치 0.69mSv)가 측정되어 유리선량계를 설치한 8개 소 가운데 가장 높은 선량률을 보였다. 이것은 일반인의 연간 유효선량한도인 1 mSv를 초과하는 값이며, 「방사선방 호 등에 관한 기준 고시」에 환경상 위해방지를 위해 규정된 연간 유효선량 0.25 mSv를 초과하는 값이다. 따라서 접 수대 근무자, 환자보호자 및 제3자 보호를 위해 핵의학과 내 환경방사선량 감소를 위한 적극적인 대책이 필요한 것으 로 나타났다. Korean individual occupational exposure control is focused on the retrospective service to the over-exposed person by the reading of personal dosimeter. Since the radiophamaceuticals using in the nuclear medicine department are uncontained radiation sources, the potential exposure at working environment is very high. Moreover, a patient remains radioactive for hours or even days after the administration of a radiopharmaceutical for diagnosis or treatment. Thus, the proper working environmental exposure control must be established and executed to protect not only the affiliated employees, but also guardians accompanying patients and temporarily visiting public from the exposure by the patients. Japanese radiation protection law regulates working environmental radiation exposure by regularly measuring and filing the environmental dose for years. This study was aimed at measuring working environmental radiation dose in the nuclear medicine department of an university hospital located in Daejeon, Korea. We measured the accumulation radiation dose in air at 8 locations in the nuclear medicine department by using the same method as in Japan with glass dosimeters. The highest dose rate, 0.23 mSv per month, was measured at the waiting room, and the second one is at reception desk. Even though the doses were lower than the Korean constraint dose rate (0.3 mSv/week) at the boundary of the radiation controlled area, it was over the dose limit of public (1 mSv/y) and environment (0.25 mSv/y). Conclusionally, it was found that the new or additional procedure was necessary to less the exposure dose to the receptionist and guardians by the environmental radiation dose in the nuclear medicine department.

방사선촬영 중 제어실 문의 열린 방향에 따른 차폐효과

최원근(Choi, Weon-Keun),김정훈(Kim, Jung-Hoon),강보선(Kang, Bo-Sun),배석환(Bae, Seok-Hwan),임창선(Lim, Chang-Seon) 한국산학기술학회 2010 한국산학기술학회논문지 Vol.11 No.9

방사선촬영검사 시에는 제어실 문을 닫고 촬영하도록 권고하고 있으나 응급 환자나 소아 환자 등의 방사선 촬영검사 시에는 발생할 수 있는 긴급 상황에 대한 신속한 조치 수행을 위해서 불가피하게 제어실 문을 열어 놓은 상태에서 촬영해야 하는 경우가 있다. 또한 일반 단순촬영의 경우에도 환자들의 대기시간 단축 등을 고려할 때 촬영 시 제어실 문을 열어 두는 것이 더 효율적일 수 있다. 이러한 상황을 감안하여 제어실 문을 열어 놓고 촬영업무를 수 행하는 경우에 방사선작업종사자에 대한 방사선피폭선량을 평가하여 방사선피폭을 최소화하면서 업무의 효율을 올릴 수 있는 방안을 모색하고자 본 연구를 수행하였다. 실제 선량률은 유리선량계를 이용하여 측정하였으며, 제어실 문이 열린 상태에서 촬영 시 방사선작업종사자 위치에서 의 선량률은 주당 100 mR(약 0.88 mGy)을 약 2.3배 초과하는 2.02 mGy가 측정되었다. 이 결과를 통해 문이 열린 경 우에는 상당량의 산란선이 작업종사자의 피폭선량을 증가시킴을 알 수 있었으며, 제어실 문이 열린 상태에서 촬영할 경우 작업종사자의 과다피폭 가능성이 매우 높다는 것을 확인하였다. 또한 몬테카를로 전산 모의실험을 수행하여 동 일한 조건에서도 제어실 문의 방향에 따라 방사선작업종사자가 위치한 곳의 선량률을 대략 1/100까지 감소시킬 수 있 음을 확인하였다. 결론적으로, 제어실 문을 열고 촬영하더라도 제어실 문의 방향에 따라 동일한 차폐효과를 기대할 수 있으므로 방사선차폐시설을 함에 있어 이에 대한 고려가 요구된다. It is recommended that the door of control room is closed during radiography to protect a radiologic technologist. However, for those patients such as of emergency or pediatrics, the door must be kept open unavoidably to apply immediate medical administration and treatment on the potential case of emergency which could be happened through the course of radiography. In addition, it could be efficient by reducing patients waiting time when the door is open for a general case. This study was conducted to evaluate practical exposure rate to a radiologic technologist when the door is open during the radiography, and to find out the ways to minimize radiation exposure and to increase the efficiency simultaneously. Measuring practical exposure rate was fulfilled with glass dosimeter, and it was 2.02 mGy/week at the location of radiologic technologist under the condition that the door is open during the radiography, which was about 2.3 times higher than the 100 mR/week. It means that the considerable amount of scattered rays through the door opening, and increase exposure rate at the radiologic technologist. Hence we confirmed that a radiologic technologist probably overexposed if the door is open during the radiography. It was also confirmed by the Monte Carlo simulation that the exposure rate could be reduced up to approximately 1/100 by change only the door opening direction. In conclusion, since the proper door opening direction provides same shielding effect whether it is open or close, the door opening direction need to be considered when it is installed at radiography facilities.