의정갈등과 필수의료, 지방의료 불균형 해결을 위한 제의

임현택,박일현 대한의사협회 2024 대한의사협회지 Vol.67 No.8

Background: The escalating conflict between the government and medical community, particularly the increase in medical school admissions by 2,000, has plunged Korea into a pressing healthcare crisis. This study delves into the heart of this dispute and proposes solutions to tackle critical issues in essential and regional healthcare. Current Concepts: Despite government assertions, the number of active physicians in Korea is increasing rapidly. With a similar physician-to-population ratio (2.65 per 1,000 inhabitants by 2022), Japan is reducing its number of medical school admissions. Korea is facing a severe shortage of essential medical fields crucial for public health, and significant regional healthcare disparities. These issues stem not from a lack of physicians, but from poor working conditions and inadequate payment systems of the National Health Insurance Services of Korea, leading to an inequitable medical ecosystem. It is crucial that policies affecting public health, such as increasing medical school admissions, are meticulously evaluated. This evaluation should consider future population projections, healthcare supply and demand systems, and financial aspects. Furthermore, any changes in medical policy should be grounded in scientific evidence and implemented in close collaboration with medical experts. Discussion and Conclusion: To effectively address imbalances in essential and regional healthcare, it is imperative to normalize the healthcare delivery system and foster an environment that motivates physicians to work voluntarily in these sectors. This change necessitates the implementation of supportive measures and financial strategies developed through extensive consultations with the medical community.

Clinical Aspects of Cerebral Venous Thrombosis: Experiences in Two Institutions

임현택,장인복,준효섭,안준형,김지희,오재근,송준호,조병문 대한뇌혈관외과학회 2016 Journal of Cerebrovascular and Endovascular Neuros Vol.18 No.3

Objective : Cerebral venous thrombosis (CVT) is a rare condition for which few clinical reviews have been conducted in Korea. Our aim was to investigate, risk factors, clinical presentations/courses, and outcomes of 22 patients treated for CVT at two centers. Materials and Methods : A retrospective analysis was conducted, selecting 22 patients diagnosed with and treated for CVT at two patient care centers over a 10-year period (January 1, 2004 to August 31, 2015). Patient data, pathogenetic concerns (laboratory findings), risk factors, locations, symptoms, treatments, and clinical outcomes were reviewed. Results : Mean patient age at diagnosis was 54.41 ± 16.19. Patients most often presented with headache (40%), followed by seizure (27%) and altered mental status (18%). Focal motor deficits (5%), visual symptoms (5%), and dysarthria (5%) were less common. Important predisposing factors in CVT included prothrombotic conditions (35%), infections (14%), hyperthyroidism (18%), trauma (14%), and malignancy (4%). By location, 9 patients (40%) experienced thrombosis of superior sagittal sinus predominantly, with involvement of transverse sinus in 20 (90%), sigmoid sinus in 12 (40%), and the deep venous system in 5 (23%). Treatment generally consisted of anticoagulants (63%) or antiplatelet (23%) drugs, but surgical decompression was considered if warranted (14%). Medical therapy in CVT yields good functional outcomes. Conclusion : Mean age of patients with CVT in our study exceeded that reported in Europe or in America and had difference in risk factors. Functional outcomes are good with use of antithrombotic medication, whether or not hemorrhagic infarction is evident.

e-Navigation을 위한 해상디지털통신 구축에 관한 정책 연구

임현택,조용갑 해양환경안전학회 2018 해양환경안전학회지 Vol.24 No.6

첨단 정보통신기술을 활용한 해양사고 감소를 위하여 국내외적으로 e-Navigation 관련 기술과 서비스에 대한 연구개발이 다양하게 진행 중이다. 이러한 기술과 서비스가 실제로 해상에서 사고예방에 기여하기 위해서는 선박에 관련 장비가 설치되어야 하며 법제적으로도 운영 조직과 시스템이 확충되어야 한다. 특히, 한국형 e-Navigation 사업으로 개발 될 초고속해상무선통신망(LTE-M망) 및 VDES, Digital-MF/HF 등 디지털 통신기술이 실행될 수 있도록 선박에는 관련 통신장비와 기술표준이 조속히 마련되어야 한다. 기존연구는 이러한 LTE-M에 대한 정책방안을 제시하지 못하는 문제점이 남아 있다. 본 연구에서는 한국형 e-Navigation의 효율적인 시행에 필요한 제도와 정책방안을 단기, 중기 및 장기로 나누어 식별하고, e-Navigation 핵심서비스, e-Navigation 통신망 및 운영시스템, e-Navigation 국제표준선도 기술 및 e-Navigation 서비스 활성화 분야에서 구체적인 방안을 제시하였다. 이를 위하여 해양수산부 주도로 추진 중인 한국형 e-Navigation 구축사업의 진도점검 자료에 기초하여 조사와 연구를 수행하였으며 관련분야 실무자 및 전문가들의 자문을 통하여 연구결론을 도출하였다. 본 연구의 결과로 제안된 정책들은 해양사고 저감과 해사산업 진흥 및 국민 안전을 위한 정부의 추가적인 정책 개발에 도움이 될 것으로 기대한다. In order to reduce marine accidents using advanced information and communication technology, various research and development projects are conducted globally on e-Navigation related technologies and services. Existing studies do not provide policy measures for LTE-M. In order for these technologies and services to be installed on vessels and to contribute to the prevention of accidents at sea, the law should be expand operational organizations and systems. In particular, communication equipment and related technical standards should be prepared, and its digital communication technology (LTE-M, VDES, Digital-MF / HF, etc.) In this study, we conducted short, medium, and long term performance assessment of the identification system and the policy for effective implementation of Korean e-Navigation. We presented a visible plan of the relevant policy. For example, e-Navigation core services, e-Navigation communication networks and operating systems, e-Navigation international standard leading technologies and e-navigation services activated in the field. To do this, we conducted research based on the progress data of the Korean e-Navigation project, which was led by the Ministry of Maritime Affairs and Fisheries, and conducted research discussions with practitioners and experts in related fields. As a result of this study, it is expected that the proposed policies will contribute to the reduction of marine accidents, the promotion of the maritime industry and the development of additional government policies for national security.

Polymeric Light-emitting Diodes Utilizing Aromatic Polyimide and Organometallic porphyrin Derivative

임현택,김휘성,이재경,김영규,이진국,조원제,하창식 한국고분자학회 1998 한국고분자학회 학술대회 연구논문 초록집 Vol.1998 No.4

Therapeutic Hypothermia for Increased Intracranial Pressure after Decompressive Craniectomy: A Single Center Experience

임현택,안준형,김지희,오재근,송준호,장인복 대한신경손상학회 2016 Korean Journal of Neurotrauma Vol.12 No.2

Objective: Therapeutic hypothermia (TH) and decompressive craniectomy are neuroprotective interventions following severe brain swelling. The precise benefits, risks, and clinical outcomes in brain swelling after TH are still being investigated. We aimed to investigate the effects of TH in severe brain injury after decompressive craniectomy. Methods: We reviewed the cases of 24 patients who underwent decompressive craniectomy with intracranial pressure (ICP) monitor insertion in one medical center between January 2012 and May 2016. All patients had an ICP greater than 15 mmHg and a Glasgow Coma Scale score of less than 7 at the time of intervention. TH was induced in half of the patients (n=12) directly after surgery; the remaining 12 patients remained normothermic. The ICP, vital signs, complications, and functional outcomes were reviewed and compared between the patient groups. Results: The mean ICP in the TH group was significantly lower than in the normothermia group. Complications during the 3 days after surgery were not different between the groups, with the exception of hypokalemia in the TH group. Mortality in the intensive care unit (ICU) was higher in the normothermia group, but the functional outcomes 3 months after surgery were not different between the TH and normothermia groups. Conclusion: TH after decompressive craniectomy was effective for lowering ICP in patients with severe brain swelling. TH also reduced mortality in the ICU, but it had no benefit in functional outcomes.

비행청소년의 자해행위에 관한 사회정신의학적 연구

임현택,민병근 중앙대학교 의과대학 의과학연구소 1982 中央醫大誌 Vol.7 No.1

The present study was intented to examine the experience rate and the general chracteristics of juvenile delinquents' self-mutilation and to clarify the correlation between adolescent self-mutilation and delinquency. A questionnaire method was used to collect the basic data for the study, in which the subjects served were consisted of 757 juvenile delinquents(male 687, female 70) in 4 randomly selected juvenile reformatories of total 11 ones in Korea. Their age range was between 12 and 21. Results of the study are as follows. 1. The experience rate of juvenile delinquents' self-mutilation was 54.3%(male 54.7%, female 50.0%), that of male being a little higher than of female. 2. Upper limbs were the most frequent body parts of self-mutilation. Among their self-reported motivations of self-mutilation, "Curiosity" was most frequent, and there was a variety of other motivations of "Uncontrollable rage." "Self-hatred," "heroic spirit", "Inducement of friends," "To threaten others," and so on. 3. The major means of self-mutilation used were "Burning with cigarette," "Broken bottle, glass fragment" and "Razor." And in the analysis by sex, there was a significant difference in that "Broken bottle,glass fragment" was more frequently used by male delinquents where as "Razor" and "Kitchen knife" were the instruments used more frequently by female delinquents. 4. More than half of the delinquent self-mutilators experienced "Feeling of repentance" after self-mutilation, and the others experienced various reactions of "Numbness," "Severe pain," "Security", "Depersonslization, and so on. 5. Among the self-mutilators around close to delinquent self-mutilators, "Close friend" and "Peer group" were most frequent, and in the analysis by age, "Family member" was more frequent in early age group, "Close friend" in middle age group, and "Peer group" in later age group respectively. 6. Rhe mean age of initial self-mutilation was 16.2(male 16.1, female 16.3), and the age range of initial self-mutilation was between 5 and 19. 74.4% of delinquent self-mutilators experienced self-mutilation for the first time before age 17, and 1.4% before age 12, too.

근로 청소년의 사회정신학적 연구 : 가정환경을 중심으로 THE FAMILY ENVIRONMENT

임현택 大韓神經精神醫學會 1979 신경정신의학 Vol.18 No.3

The present research was performed to identify any characteristics of adolescent workers' family environments and to use them as a basic material for total adolescent workers' mental health. The data were obtained from worker groups of various ages with questionnaire method. The subjects were consisted of 393 male and female workers of age ranged from 12 to 21, working at four factories in the suburbs of Seoul in Sept. of 1978. The summary of the results are as follow. 1. In the parents' educational level, "Under primary school" and "Primary school" groups were most common (father; 52.7%, mother; 73.7%), and this tendency of the parents' low educational level is positively related with the adolescent workers of lower eucational level and from rural area. 2. In the parents' occupation, "Occupation requiring simple skill" was most common in fathers (69.5%) and "Unemployed" in mothers (78.4%) respectively. 3. The most common main source of family income was "Father"(64.6%), "Mother" (10.9%), "Adolescent worker"(0.8%), "The other siblings or relatives"(23.7%). As in the adolescent workers' educational level, higher the workers' educational level, more the cases of "Mother" and lower the workers' educational level, more the cases of "Father" in the main source of family income. 4. More than half of the adolescent workers live separated from their families, whose main resident places are "Cooking for oneself" or "Lodging"(65.7%). 5. The family problems that the workers recognize was most commonly "Economic problem"(50.6%). And also, "Economic problem" was considerasly ably common in the reasons of temporary parental separation(31.0%), and this tendency was more prominent among the workers from "Seoul" and of lower educational level. 6. The most common parental marital bonds in their family dynamics were "Accepting parent"(36.4%), "Marital skew"(30.0%), and "Alcoholic bond"(16.5%). As in the sexual difference, "Marital skew" was most common in male workers, whereas "Accepting parent" was most common in female workers.

풍수해 개별보험요율 산정을 위한 위험도 가중치 산정 기법

임현택,김정면,이충원,박성용,지연구,김용성 한국방재학회 2015 한국방재학회논문집 Vol.15 No.2

The storm and flood insurance is currently growing as a national disaster management insurance against natural disasters. In current storm and flood insurance rate system, however, weighted rates for the sources of natural disasters (flood, wind, snow etc.) are not only considered, but also single insurance rate is applied to a total of 229 cities and districts without considering regional risks. In the present study, therefore, different insurance rates according to the sources of natural disasters, reflecting regional risks, were estimated and finally reasonable weighted rates were proposed based on the estimated results. 풍수해보험은 풍수해 대비를 위한 국민 재난관리보험으로 성장하고 있다. 그러나, 현행 풍수해 보험요율체계는 재해원인별(수해·풍해·설해 등)에 대한 가중치가 명확하게 분석·고려되고 있지 않는 실정이며, 보험목적물(주택, 비닐하우스 등)이 위치하고 있는 지역의위험도와 관계없이 229개 지자체(시·군·구)별로 각각 하나의 위험등급으로 요율을 적용하고 있어 보험목적물이 위치하고 있는 지역의 재해원인별 위험도에 따라 요율의 합리적 차별화가 필요하다. 따라서, 본 연구에서는 지역별로 각각 하나의 위험등급으로 적용되고있는 보험요율의 대안으로 풍수해 보험요율 산정에 필요한 재해원인별(수해·풍해·설해 등) 가중치를 산정함으로써, 지역별 재해 위험도를 반영한 차등화 된 보험요율 산정에 적용할 수 있는 재해원인별 가중치를 제안하였다.

음악교육의 관점에서 바라본 정간보 창안의 주체

임현택 한국공연문화학회 2018 공연문화연구 Vol.0 No.36

On September 23, 2015, the Ministry of Education announced the 2015 revision of educational curriculum which aimed at ‘cultivating creative talents’ based on the Article 23, Section 2 of the Elementary and Secondary Education Law. As a result, music curriculum have also been partially revised, which seems to maintain the 2009 revision of music curriculum. Although Jeongganbo 井間譜 is already exposed in the music curriculum for the third and forth grades of elementary school, the learning content about how to read Jeongganbo and how to express the pitch and length of sound including the origin of its name and the background of its invention are dealt with specifically in the fifth and sixth grades. Jeongganbo is known as the oldest mensural notation in the Orient created by King Sejong of the Joseon Dynasty in the middle of the 15th century, and it was used for the first time in Sejong sillok akbo 世宗實錄樂譜 (Scores in the Annals of King Sejong), the oldest musical score still in existence. However, in the music textbooks as well as the most of specialized books related to the Korean traditional music, it is uncritically accepted without providing clear grounds that Sejong invented Jeongganbo himself. If so, it is necessary to investigate on which grounds it is claimed that Sejong invented Jeongganbo. This paper first examined the grounds of the proposition that “Sejong invented Jeongganbo,” which is introduced in the music textbooks for the fifth and sixth grades of elementary school, by separating it into Sejong’s creation of Sinak 新樂 (new music), Sejo’s invention of Jeongganbo and Sejong’s invention of Hangeul. Next, this paper examined how the subject of the invention of Jeongganbo has been described in the textbooks for the fifth and sixth grades in elementary school based on the 2009 revision of music curriculum, and suggested the direction of a desirable music education by pointing out the related problems. According to historical records and circumstances such as Sejong’s creation of Sinak, Sejo’s invention of Jeongganbo with 16 Jeonggan (square) in one vertical line, Sejong’s invention of Hangeul and so on, it seems to be the most reasonable that Sejong is the subject of the invention of Jeongganbo as of now. However, the attitude of the musical academy to accept and educate the unclear thing as if it is a fact does not seem desirable. Therefore, I suggest that it should be described “Jeongganbo was invented in the period of Sejong” or “it is supposed that Jeongganbo was invented by Sejong” rather than presenting “Sejong made Jeongganbo” or “created” until revealing the clear evidence about the subject of Jeongganbo. 2015년 9월 23일 교육부는 초ㆍ중등교육법 제23조 제2항에 의거하여 ‘창의융합형 인재 양성’을 지향하는 2015 개정 교육과정을 고시하였다. 이에 따라 음악과 교육과정 또한 일부 개정되었는데, 그 큰 틀은 2009 개정 음악과 교육과정을 유지하고 있는 것으로 보인다. 음악과의 영역 안에서 정간보는 초등학교 3∼4학년의 교육과정에서 이미 노출되고 있기는 하지만, 정간보의 명칭 유래 및 창안 배경을 비롯한 악보 읽는 방법, 음높이 및 음길이 나타내는 방법 등에 관한 학습 내용은 5∼6학년에서 구체적으로 다루어지도록 되어 있다. 정간보는 15세기 중엽 조선조 세종에 의해 창안된 동양에서 가장 오래된 유량악보로 알려져 있으며, 현전하는 악보 중 가장 오래된 악보인 『세종실록악보』에서 처음으로 사용되었다. 그런데 대부분의 국악 관련 전문서적은 물론이거니와 음악교과서에서는 분명한 근거를 제시하지 않은 채 세종이 정간보를 창안한 주체임을 무비판적으로 수용하고 있다. 그렇다면 과연 어떤 근거에 입각하여 세종이 정간보를 창안하였다고 주장하는지 가려낼 필요가 있겠다. 본고에서는 먼저 초등학교 5∼6학년 음악교과서에서 소개되는 ‘세종이 정간보를 창안하였다’는 명제에 대한 근거를 세종의 신악 창제, 세조의 정간보 창작, 세종의 한글 창제로 구분하여 살펴보았다. 다음으로 2009 개정 음악과 교육과정을 바탕으로 발행된 초등학교 5∼6학년 6종 검정교과서를 대상으로 정간보 창안의 주체가 어떻게 기술되어 있는지 살펴보고, 그에 따른 문제점을 지적함으로써 바람직한 음악교육의 방향성을 제시하고자 하였다. 세종의 신악 창제, 세조에 의한 1행 16정간의 정간보 제작, 세종의 한글 창제 등 역사적 기록 및 정황들을 종합해 보면, 세종이 정간보의 창안 주체임이 현재로서는 가장 타당해 보인다. 그러나 이러한 가능성만으로 명확하지 않은 일을 마치 사실인 것처럼 받아들이며 교육하는 음악학계의 태도는 바람직해 보이지 않는다. 따라서 필자는 정간보 창안의 주체자에 대한 명확한 근거가 드러나기 전까지 “세종이 정간보를 만들었다” 또는 “창안하였다”는 내용으로 기술하기보다는 “정간보는 세종조에 창안되었다” 또는 “정간보는 세종에 의해 창안된 것으로 추정된다”로 바꾸어 기술할 것을 제안하는 바이다.

2P-619 Refiner와 Valley Beater의 고해 효율 비교 분석

임현택,김철환,이지영,권솔,박형훈,구호경 한국공업화학회 2017 한국공업화학회 연구논문 초록집 Vol.2017 No.1

현재 국내에서의 실험실 조건에서 Refining연구는 대부분 Valley beater를 이용하여 진행되고 있다. 하지만 실제 공정에서의 Refining은 주로 Conical refiner 혹은 Disk refiner를 사용하여 진행이 되기 때문에 연구와 실제 공정에서의 차이점이 드러나는 경우가 많다. 이러한 문제점을 해결하기 위해 실험실 조건에서의 Single disk refiner를 이용하여 실제 공정에 적용을 용이하게 만들었다. 본 연구에서는 침엽수와 활엽수 크라프트 펄프를 4%의 지료로 만들어 Refining을 진행하였고, 직접 제작한 활엽수 Refiner plate와 침엽수 Refiner plate를 이용하여 고해를 실시한 후 Valley beater의 고해 효율과 비교 분석하였다.