• Title/Summary/Keyword: 의료 지도

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The Spatial Disparity of Opportunity Potentials in Korea (한국 도시의 경제 $\cdot$ 문화 $\cdot$ 사회 복지적 기회 잠재력의 지역적 격차)

  • Choi, Yoon-Jeong;Lee, Keumsook
    • Journal of the Economic Geographical Society of Korea
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    • v.8 no.1
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    • pp.91-105
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    • 2005
  • The assessment (or the evaluation) of spatial disparity is the main concern for the study of spatial disparities or spatial inequalities. In order to evaluate the spatial disparity, the regional differences have to be counted quantitatively. Several measurements have been introduced for evaluating the development potentials of each region. Most of them are the composite indices of the socio-economic variables rather than the real potentials of the region. This study attempts to investigate the spatial disparity in Korea. For the purpose, the levels of opportunity potentials of the cities have been calculated by the Potential Model redefined by Lee(1995). The opportunity potentials have been calculated for the educational, cultural, medical service, environmental sectors, income, and consumption sectors, and the spatial patterns of various opportunity potentials have been analyzed. The spatial patterns of opportunity potentials show the severe concentration on the Metropolitan Seoul area through all sectors. The next level concentration appears at the other end of the Keuyng-Bu axis. And the cities relatively high opportunity potential values are distributed along the Keuyng-Bu axis. Remain parts of the country show quietly low opportunity potential values. In particular, the southern-west and the northern-east parts show relatively very low values. This pattern appears for all sectors except for the opportunity potential of the environmental sector. It means that the spatial disparity in Korea have been promoted and enhanced by the national development policies concentrated the investment on the large cities along the Keuyng-Bu axis during the last 40 years.

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Clinical Characteristics of Pleomorphic Carcinoma (다형성 암종의 임상적 고찰)

  • Lee, Deok-Heon;Park, Hoon;Park, Chang-Kwon;Kwon, Kun-Young;Park, Nam-Hee;Choi, Sae-Young;Lee, Kwang-Sook;Yoo, Young-Sun
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.397-403
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    • 2003
  • Background: The research sought to identify the clinical features of pleomorphic carcinoma of the lung generally known as a rare subtype in accordance with the lung cancer classification done in 1999 by WHO. Material and Method: 250 cases of surgically resected lung cancers were collected in this hospital from January 1992 to December 2001. This study included 42 cases of pleomorphic carcinoma diagnosed through light microscope and immunohistochemistry. Result: Out of 42 cases, males represented 31, and females 11, the age ranged from 26 to 77. Main clinical symptoms included coughing, hemoptysis, sputum. Diagnoses disclosed the stage as stage la in 3 cases (7%), Ib in 16 (38%), IIa in 1 (2%), IIb in 8 (19%), IIIa in 15 (35%), and IIIb in 1 (2%). Out of these, no lymph node metastasis was represented in 23 cases (54%), while N1 and N2 involving lymph node metastasis was shown 19 cases (46%). A total of 19 patients developed metastasis, comprising the brain in 5 cases (26%), bone in 4 (21%), muscle in 4 (21%), Lymph node in 2 (10%), and 1 liver, ovary, contralateral lung, and adrenal gland, respectively. The size of the tumor ranged from 1 cm to 11 cm, averaging 5.85 cm. Out of the 42 patients, the total two-year and five-year survival rates in accordance with the Kaplan-Meier method represented 26% and 13%, respectively, These figures compared to the corresponding 44% and 34% in cases other than pleomorphic carcinoma from the survey target of 256 cases, proved to be significantly low (p<0.002). No significant difference was found in the survival rates compared between age and tumor size, between stage I and above stage II, and between N0 and above N1. Patients who developed postoperative metastasis all died, and showed significantly low survival rates (p<0.002) compared to those patients without metastasis. Conclusion: With the new diagnosis method of f999 WHO's lung cancer classification applied, pleomorphic carcinoma showed a higher prevalence rate than under previous classifications, their postoperative survival rate was significantly low compared to histologic type of non small cell lung carcinomas.

Analysis of the Perception of Hospice and Narcotic Analgesics by Family Caregivers of Terminal Cancer Patient (말기 암 환자 보호자의 호스피스와 마약성 진통제에 대한 인식도 분석)

  • Kwak, Kyung-Sook;Chun, Sung-Ho;Ha, Jung-Ok;Lee, Kyung-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.106-111
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    • 2006
  • Purpose: In terminal cancer patients, pain control with narcotic analgesics and supportive care by hospice are very useful treatment modality. However, many patients and their caregivers are poorly compliant in using narcotic analgesics for fear of addiction and tolerance. And also many patients and family caregivers are reluctant to accept hospice, presuming that hospice means patient's condition is no longer reversible and progressively deteriorating. The purpose of this study was to evaluate and analyze the perception of using narcotic analgesics and hospice by family caregivers of terminal cancer patients who play a critical role in health care in Korean culture. Methods: A total of 54 terminal ranter patient's family caregivers participated in this study. Questionnaire consisted of 15 questions about narcotic analgesics and hospice. Results: The study revealed following results. 1) family caregivers who are not aware of hospice are more than half (56.7%). 2) 81.8% of family caregivers agreed that hospice care is beneficial to terminal cancer patients. 3) 85.1% of family caregivers were under financial burden. 4) 83.2% of patient complained pain in 24 hours. 3) while 88.5% of family caregivers believed that narcotic analgesics can control pair, 79.1% and 79.6% of them also believed that use of narcotic analgesics would result in addiction and tolerance, respectively. Conclusion: There still exist barriers to family caregivers in using narcotic analgesics for pain control. And also, terminal cancer patient's family caregivers have poor information about hospice. Therefore, educational intervention about narcotic analgesics by pharmacist and doctors are needed for proper pain control for terminal ranter patients. In addition, more precise information about hospice care should be provided for terminal cancer patients and their family caregivers.

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Meta-Analysis about Effect of Aromatherapy on Stress (향기요법이 스트레스에 미치는 효과에 대한 메타 분석)

  • Kim, Gyung-Duck;Suh, Soon-Rim
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.188-195
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    • 2008
  • Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.

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A Study on the Patient Exposure Doses from the Panoramic Radiography using Dentistry (치과 파노라마 촬영에서 환자의 피폭선량에 관한 연구)

  • Park, Ilwoo;Jeung, Wonkyo;Hwang, Hyungsuk;Lim, Sunghwan;Lee, Daenam;Im, Inchul;Lee, Jaeseung;Park, Hyonghu;Kwak, Byungjoon;Yu, Yunsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.17-24
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    • 2013
  • This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is $413.67{\pm}6.53{\mu}Gy$ and each upper, lower lips is $217.80{\pm}2.98{\mu}Gy$, $215.33{\pm}2.61{\mu}Gy$. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are $30.73{\pm}2.34{\mu}Gy$, $31.87{\pm}2.50{\mu}Gy$, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.

The Study for Optimal Exposure Condition of Chest Examination of Digital Radiography System (디지털 방사선 촬영장치의 흉부촬영 최적 조사조건에 관한 연구)

  • Park, Ji-Koon;Jung, Bong-Jae;Park, Hyong-Hu;Noh, Si-Cheol;Kang, Sang-Sik
    • Journal of the Korean Society of Radiology
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    • v.10 no.2
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    • pp.109-115
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    • 2016
  • Despite of increasing the use of the digital imaging device in the radiology area, the setting on the optimal irradiation conditions are insufficient. In this study, the exposure dose and image quality by exposure condition of digital radiography device were compared. The exposure doses were obtained by adjusting the exposure condition as 5 steps respectively based on the exposure conditions that are currently used of CR and DR radiography devices. The acquired image has been assessed by 20 medical image professors using the assessment method of the Japanese Society for Tuberculosis Prevent. As a result, in the case of the CR system, the better image quality was obtained in the condition of 120 kVp and 1.5 mAs~2.4 mAs (quality score 91~95.5 points) than standard exposure condition(110 kVp, 3.2 mAs, 86 points). And exposure dose was evaluated as low with $61.3{\sim}98.4{\mu}Gy$ than standard condition($105.11{\mu}Gy$). In DR system, however, the image quality score was higher as 97~98.6 points in the lower tube voltage range (112 kVp, 2.4~3.2 mAs) condition than the standard exposure condition (125 kVp, 3.2 mAs, 91 points). In addition, the exposure dose was $61.5-77.2{\mu}Gy$ lower than standard condition($93{\mu}Gy$). In addition, the exposure dose was low as $61.5-77.2{\mu}Gy$ than standard condition($93{\mu}Gy$). With the results of this study, we confirmed that it is possible to reduce the patient exposure dose with the same image quality by adjusting the optimal exposure condition of digital device.

Analyzing Contextual Polarity of Unstructured Data for Measuring Subjective Well-Being (주관적 웰빙 상태 측정을 위한 비정형 데이터의 상황기반 긍부정성 분석 방법)

  • Choi, Sukjae;Song, Yeongeun;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.22 no.1
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    • pp.83-105
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    • 2016
  • Measuring an individual's subjective wellbeing in an accurate, unobtrusive, and cost-effective manner is a core success factor of the wellbeing support system, which is a type of medical IT service. However, measurements with a self-report questionnaire and wearable sensors are cost-intensive and obtrusive when the wellbeing support system should be running in real-time, despite being very accurate. Recently, reasoning the state of subjective wellbeing with conventional sentiment analysis and unstructured data has been proposed as an alternative to resolve the drawbacks of the self-report questionnaire and wearable sensors. However, this approach does not consider contextual polarity, which results in lower measurement accuracy. Moreover, there is no sentimental word net or ontology for the subjective wellbeing area. Hence, this paper proposes a method to extract keywords and their contextual polarity representing the subjective wellbeing state from the unstructured text in online websites in order to improve the reasoning accuracy of the sentiment analysis. The proposed method is as follows. First, a set of general sentimental words is proposed. SentiWordNet was adopted; this is the most widely used dictionary and contains about 100,000 words such as nouns, verbs, adjectives, and adverbs with polarities from -1.0 (extremely negative) to 1.0 (extremely positive). Second, corpora on subjective wellbeing (SWB corpora) were obtained by crawling online text. A survey was conducted to prepare a learning dataset that includes an individual's opinion and the level of self-report wellness, such as stress and depression. The participants were asked to respond with their feelings about online news on two topics. Next, three data sources were extracted from the SWB corpora: demographic information, psychographic information, and the structural characteristics of the text (e.g., the number of words used in the text, simple statistics on the special characters used). These were considered to adjust the level of a specific SWB. Finally, a set of reasoning rules was generated for each wellbeing factor to estimate the SWB of an individual based on the text written by the individual. The experimental results suggested that using contextual polarity for each SWB factor (e.g., stress, depression) significantly improved the estimation accuracy compared to conventional sentiment analysis methods incorporating SentiWordNet. Even though literature is available on Korean sentiment analysis, such studies only used only a limited set of sentimental words. Due to the small number of words, many sentences are overlooked and ignored when estimating the level of sentiment. However, the proposed method can identify multiple sentiment-neutral words as sentiment words in the context of a specific SWB factor. The results also suggest that a specific type of senti-word dictionary containing contextual polarity needs to be constructed along with a dictionary based on common sense such as SenticNet. These efforts will enrich and enlarge the application area of sentic computing. The study is helpful to practitioners and managers of wellness services in that a couple of characteristics of unstructured text have been identified for improving SWB. Consistent with the literature, the results showed that the gender and age affect the SWB state when the individual is exposed to an identical queue from the online text. In addition, the length of the textual response and usage pattern of special characters were found to indicate the individual's SWB. These imply that better SWB measurement should involve collecting the textual structure and the individual's demographic conditions. In the future, the proposed method should be improved by automated identification of the contextual polarity in order to enlarge the vocabulary in a cost-effective manner.

Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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Radioactivation Analysis of Concrete Shielding Wall of Cyclotron Room Using Monte Carlo Simulation (PET 사이클로트론 가동에 따른 콘크리트 차폐벽의 방사화)

  • Jang, Donggun;Lee, Dongyeon;Kim, Junghoon
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.335-341
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    • 2017
  • Cyclotron is a device that accelerates positrons or neutrons, and is used as a facility for making radioactive drugs having short half-lives. Such radioactive drugs are used for positron emission tomography (PET), which is a medical apparatus. In order to make radioactive drugs from a cyclotron, a nuclear reaction must occur between accelerated positrons and a target. After the reaction, unncessary neutrons are produced. In the present study, radioactivation generated from the collisions between the concrete shielding wall and the positrons and neutrons produced from the cyclotron is investigated. We tracked radioactivated radioactive isotopes by conducting experiments using FLUKA, a type of Monte Carlo simulation. The properties of the concrete shielding wall were comparatively analyzed using materials containing impurities at ppm level and materials that do not contain impurities. The generated radioactivated nuclear species were comparatively analyzed based on the exposure dose affecting human body as a criterion, through RESRAD-Build. The results of experiments showed that the material containing impurities produced a total of 14 radioactive isotopes, and $^{60}Co$(72.50%), $^{134}Cs$(16.75%), $^{54}Mn$(5.60%), $^{152}Eu$(4.08%), $^{154}Eu$(1.07%) accounted for 99.9% of the total dose according to the analysis having the exposure dose affecting human body as criterion. The $^{60}Co$ nuclear species showed the greatest risk of radiation exposure. The material that did not contain impurities produced a total of five nuclear species. Among the five nuclear species, 54Mn accounted for 99.9% of the exposure dose. There is a possibility that Cobalt can be generated by inducive nuclear reaction of positrons through the radioactivation process of $^{56}Fe$ instead of impurities. However, there was no radioactivation because only few positrons reached the concrete wall. The results of comparative analysis on exposure dose with respect to the presence of impurities indicated that the presence of impurities caused approximately 98% higher exposure dose. From this result, the main cause of radioactivation was identified as the small ppm-level amount of impurities.