• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.753-760
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• 2018

Objective : We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs). Methods : We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans ($CK_{original}$) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at low-isodose levels (10-30% of prescription dose) for dose spillage. In each case, a modified CK plan ($CK_{modified}$) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared. Results : There were no differences in the conformity indices among the $CK_{original}$, $CK_{modified}$, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the $CK_{modified}$ plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the $CK_{original}$ plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345). Conclusion : These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.

• 한국건축시공학회지
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• 제20권3호
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• pp.269-278
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• 2020

본 연구에서는 건설현장 중 아파트 건설현장에서 발생한 산업재해에 대해 분석하고 업무상 재해 유형에 따른 재해요인을 다중 상응 분석을 통해 연관성을 분석하였다. 국내에서 세 번째로 재해빈도가 높은 아파트 건설현장에 대한 재해 관련 연구가 부족하고 설문 조사 기법을 활용한 연구들이 대부분이다. 따라서 본 연구에서는 산업재해원인조사 데이터에서 탐색적 데이터 분석을 진행하고 다중 상응 분석을 통해 각 재해요인 간의 연관성을 도출하였다. 연구의 결과를 두가지로 요약하면 다음과 같다. 첫째, 최근 아파트 시공이 초고층화 및 설계의 복잡화로 인해 고소작업이 많아짐에 따라 추락재해가 높은 빈도와 근로자의 사망률을 나타냈다. 또한, 사망은 경력이 매우 적은 작업자와 10년 이상의 경력을 가진 작업자가 대부분을 차지하고 있으며, 이는 안전교육 미실시, 경험 부족 그리고 근로자의 안전불감증으로 인해 발생하는 것으로 나타났다. 둘째, 다중 상응 분석 결과 대부분 발생하는 산업재해는 안전장비 착용, 올바른 작업절차 준수 및 관리·감독으로 충분히 예방할 수 있는 것으로 나타났다. 본 연구에서 도출된 중점 재해요인은 아파트 건설현장의 안전교육과 감독·관리에서 사용할 수 있을 것으로 판단된다.

• 한국콘텐츠학회논문지
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• 제12권9호
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• pp.57-67
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• 2012

배우가 어떤 과정을 통해 인물이 되는가에 관해서는 많은 혼란이 존재한다. 인물이 되어야 한다는 압박감은 배우들로 하여금 자신을 저버리고 무작정 다른 존재가 되도록 요구하고, 그에 따라 인위적이고 상투적인 연기의 함정에 빠지기 쉽다. 모든 예술은 정직하게 자기 자신에게서 시작된다. 벗어날 수 없는 일상속에 얽매인 나와 무한한 가능성을 지닌 자유로운 존재로서의 나를 구분해야만 어떻게 나에게서 시작해서 나를 버리고 나를 넘어설지를 모색할 수 있다. 살아있는 인물이 되고자 하는 배우는 연기하려고 하지 말고, 경험하려고 하여야 한다. 경험하기 위해서는 반응해야 한다. 반응하기 위해서는 오감의 경험에서 시작하여야 한다. 인물도 우리 모두와 마찬가지로, 오감의 경험에 반응하고, 반응에 반응하면서, 그리고 상상력이 빚어내는 이미지들에 반응하면서 세상에 존재하고 살아가는 것이다. 배우는 자신의 감각과 기억, 그리고 상상력만을 가친 채 극적 상황이라는 가상의 절박한 상황에 던져진다. 낯선 상황에 직면해 알지 못하는 것에 대한 두려움을 갖는 것은 자연스러운 일이나, 그 두려움에 억매여 있으면 아무것도 제대로 하지 못한다. 경험을 해가면서 인물을 내 몸과 마음이 저절로 이해하게 해야 한다. 알아서 하는 것이 아니라, 모르기 때문에 하는 것이고, 하면서 그리고 하기 때문에 알게 되는 것이다. 인물이 된다는 것은 미지의 여행에서 새로운 경험을 하면서 새로운 나를 끊임없이 발견하는 것이다.

• 정보화정책
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• 제28권3호
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• pp.3-22
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• 2021

개념 정리도 되지 않은 채, 언론과 업계에서는 메타버스에 대한 다양한 논의가 진행 중이다. 스티븐슨(Neal Stephenson)의 소설 '스노우 크래쉬(Snow Crash, 1992)'에서 용어가 처음 사용된 이래로, 미국의 미래가속화연구재단(Acceleration Studies Foundation: ASF)이 2007년 메타버스 개념을 처음 정리했지만 이후 메타버스는 오랫동안 주목을 받지 못했다. 그러나 2020년 가을 엔비디아(NVIDIA)가 실시간 3D 시각화 협업 플랫폼 '옴니버스(Omniverse)'를 소개하며 제2의 인터넷으로 메타버스를 설명하고, 로블록스(Roblox)가 기업공개(IPO)를 하며 자사의 서비스를 메타버스로 설명하면서, 메타버스는 현실과 가상의 경계를 넘나드는 새로운 세상으로 인식하게 됐다. 이 연구는 어느새 미디어와 콘텐츠를 넘어 새로운 삶의 공간으로 그려지는 메타버스에 대한 다양한 논의를 정리하고, 메타버스에 대한 새로운 정의를 제안하고자 한다. 메타버스의 의미를 설명하기 위해서 ASF가 제안한 두 개의 축과 네 개의 시나리오를 중심으로 가상세계, 거울세계, 증강현실, 라이프로깅의 의미를 다양한 연구를 통해 연구를 통해 정리한 후에, 메타버스 설명의 문제점을 비판하고 대안으로 인간 중심, 사용자 중심의 메타버스 정의로 인간 커뮤니케이션, 현실, 비현실 경험, 그리고 확장현실을 제안하며, 메타버스에 대한 재개념화를 시도했다.

• 한국산학기술학회논문지
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• 제22권3호
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• pp.633-642
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• 2021

본 연구에서는 외국인 유학생들의 온라인 수업 경험을 탐색하기 위하여 합의적 질적연구(CQR)의 절차와 방법에 따라 연구를 수행하였다. 2020년 1학기와 2학기, 국내 대학에 재학한 중국 국적 유학생으로 모집하여 총 15명에 대해 온라인 심층면담을 실시했으며, 4개 영역별로 13개 범주와 36개 하위범주가 도출되었다. 외국인 유학생들은 온라인 수업의 편의성과 맞춤학습을 장점으로, 학습동기 및 집중력 저하를 단점으로 인식하는 것으로 나타났다. 온라인 수업에서 학업량과 학업투자 시간 증가를 경험하는 것으로 나타났으며, 온라인 학습을 위해 개인적인 학습전략 활용과 함께 친구 및 학교로부터의 도움을 함께 활용하는 것으로 나타났다. 또 유학생들은 온라인 수업에서 수업 수업공지 및 안내관련 문제와 수업환경 및 기술적 어려움, 교수자와의 상호작용 어려움을 겪고 있는 것으로 나타났으며, 온라인 학습 개선 필요 사항에서는 교수자의 수업이해 및 향상 참여 유도 필요, 학생 스스로 자기주도적 학습능력 강화와 수업 환경측면에서 수업 안내 및 학습지원강화가 필요한 것으로 나타났다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.122-128
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• 2008

Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions.

• 보건행정학회지
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• 제13권3호
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• pp.52-70
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• 2003

The rate of conversion to Medical-juridical-persons' ownership of medical institutions has increased rapidly since its start in 1970s in Korea. The most sensitive issue to introduce for-profit medical institutions, ignited particularly by the WTO/DDA negotiations, has sparked considerable debate, stemming largely from conflicting views on the theoretical effects of ownership status on organizational behavior. This study surveyed health-related experts' opinions on allowing for for-profit-firms-owned medical institutions. Some fear that the obligation to maximize the share-holders' return on their investment will cause the medical institutions to eliminate necessary but less lucrative services. They may easily fall under more pressure to generate income, and respond more aggressively than not-for-profit medical institutions to financial pressures. Advocates of for-profit ownership of medical institutions argue that greater responsiveness to the demands of the marketplace will lead to larger investment, higher quality and lower costs to consumers. Referring to both foreign countries' experience and domestic experts' opinions, this study suggests for reform of the current Korean Medical-Juridical-Person(MJP) System. Introduction of so-called “Capital-investment” MJPs is recommended where the properties left in case of their dissolution can be distributed to original investors according to the procedures stipulated in their statutes. However, their annual profits are not allowed to be allocated to investors, but should be reinvested for their medical institutions, as is the case in current MJPs. Their legal aspects are also reviewed in this study.

• 한국응급구조학회지
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• 제17권3호
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• pp.9-20
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• 2013

Purpose: This research project addressed the need to designing more safe and efficient interior of the future ambulance in Korea. Methods: The study sample contained 760 paramedics in 4 districts. Data was collected by using a revised and complemented questionnaire based on literature review. Results: In relation to the efficacy and safety of work, answers related to storage closet showed to be the highest, and the most difficult part of paramedic work in an ambulance was lurching. CPR is the most frequently used emergency care inside an ambulance, but 66% of the paramedics responded that accurate CPR is not possible during vehicle transfer. Safety belts are not worn for 82.8% of the time, because of discomfort (51.3%). 13.8% of the paramedics responded that stretchers are unstable, 29.5% had an experience of having patients fall off the stretcher inside an ambulance. There were comments on installing equipments to prevent noise, and assist communication. Conclusion: The suggested practical layout contains five main modifications 1. Developing specially designed belt is needed for paramedic safety & efficient work. 2. The seats are molded to be ergonomically friendly. 3. Equipments to secure the body and safety devices for CPR are needed. 4. System improvement for communication between the driver seat and paramedics is needed. 5. The stretchers are molded to be maximize efficiency and minimize injury.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.33-40
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• 2017

Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.560-564
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• 2008

Purpose: Because of traffic accidents and many criminal violences, the incidence of facial trauma has been increasing not only in adults but also in children. We planed this study to introduce our experience about pediatric blow out fracture and provide more information. Methods: We made retrospective study in 76 children with blow out fracture from January 2001 to September 2005 by retrospective chart review including detailed preoperative and postoperative evaluations, age, sex, cause, symptom and sign, and their post-operative complications. Results: Among our patients, 69 were male and 7 were female. The ages ranged from 7 to 18 years, which shows the greatest incidence of blow out fracture. Physical violence(46%) was the most common cause in this group and was followed by vehicle accident(28%), and fall down accident(17%). Left side(64%) showed slightly more incidence than right side(36%), but there were no statistical importance. Ecchymosis(88%) was the most common symptom and followed by periorbital swelling(68%) and diplopia(30%). 30 patients was diagnosed with another facial bone fracture and nasal bone(51%) was the most common associated facial bone fracture. Fourty four Patients(60%) got an orbital wall reconstruction in 7 days after trauma. After the operation, only 3 patients(4%) suffered from diplopia postoperative 3 month, and resolved in 4 years. Conclusion: The incidence of blow out fracture in children has been increasing every year, and violence has become more important etiology of pediatric blow out fracture and public and private education institutions were the most common place that blow out fracture originated. Accurate diagnosis and careful treatment plans are important in pediatric blow out fracture.