• 대한의용생체공학회:의공학회지
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• 제28권5호
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• pp.657-664
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• 2007

Stroke patients need regular medical treatments and rehabilitation training from their doctors. However, severe aftereffects caused by stroke allow them minimum activities, which make it difficult for them to visit doctor. Recently, electric brain stimulation treatment has been found to be better way compared to conventional ones and many are interested in using this method for the treatment of stroke. In this study, we have developed a remote medical treatment system using wireless electric brain stimulator that can help the stroke patients to get a treatment without visiting their doctors. The developed remote medical treatment system connects the doctors to the brain stimulator implanted in the patients via the internet and ZigBee communication built in the brain stimulator. Also, the system receives personal information of the connected patients and cumulates the total records of electric stimulation therapy in a database. Doctors can easily access the information for better treatment planning with the help of graphical visualization tools and management software. The developed remote medical treatment system can be applied to the electric stimulation treatments for other brain diseases with a minor change.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.42-49
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• 2015

Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.

• 한국비블리아학회지
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• 제21권3호
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• pp.45-56
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• 2010

본 연구는 한국의학도서관협의회 소속의 대학 및 병원도서관을 대상으로 웹사이트 구축현황을 살펴보고, 나아가 웹사이트를 운영하고 있는 국내 29개 의과대학도서관 웹사이트의 메뉴구성과 콘텐츠를 비교, 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 의학도서관 웹사이트의 메인메뉴는 소장자료검색, 전자정보원, 도서관서비스, My Library, 도서관안내, 게시판의 6개로 정리된다. 둘째, 의학도서관 웹사이트에서 제공하는 주요 정보서비스는 '자관 Pubmed, 원문복사/상호대차, 정보검색, 이용교육, 논문작성지원, SDI서비스, 모바일서비스, 학위논문제출, 참고정보원, 교외접속, 주제별서비스, 인용정보분석, 대출예약/연기, 희망도서신청, Q&A게시판'의 15가지이다. 셋째, 가장 많은 기관에서 제공하고 있는 정보서비스는 원문복사/상호대차이며, 다음은 '대출예약/연기, 희망도서신청, 교외접속, 이용교육, 참고정보원, Q&A게시판, 자관 Pubmed, 학위논문제출' 등의 순이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3463-3471
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• 2015

Background: The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the womans perspective. Materials and Methods: In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Programme (CASP) tool was used. Results: From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. Conclusions: Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening.

• Clinical and Experimental Pediatrics
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• 제56권9호
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• pp.396-400
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• 2013

Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA) by using an Amplatzer vascular plug (AVP). Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared. Results: The mean age of the patients was $54.9{\pm}45.7$ months old. The PDAs were of type C (n=5), type D (n=12), and type E (n=3). The mean pulmonary end diameter of the PDA was $1.7{\pm}0.6$ mm, and the aortic end diameter was $3.6{\pm}1.4$ mm. The mean length was $7.3{\pm}1.8$ mm. We used 3 types of AVP devices: AVP I (n=5), AVP II (n=7), and AVP IV (n=8). The ratio of AVP size to the pulmonary end diameter was $3.37{\pm}1.64$, and AVP size/aortic end ratio was $1.72{\pm}0.97$. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P=0.002). The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter ($1.10{\pm}0.31$, P=0.032). Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

• International Journal of Fuzzy Logic and Intelligent Systems
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• 제14권4호
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• pp.268-275
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• 2014

In future, hospitals are expected to automatically issue remote transcriptions. Many general hospitals are planning to encrypt their medical database to secure personal information as mandated by law. The electronic medical record system, picture archiving communication system, and the clinical data warehouse, amongst others, are the preferred targets for which stronger security is planned. In the near future, medical systems can be assumed to be automated and connected to remote locations, such as rural areas, and islands. Connecting patients who are in remote locations to medical complexes that are usually based in larger cities requires not only automatic processing, but also a certain amount of security in terms of medical data that is of a sensitive and critical nature. Unauthorized access to patients' transcription data could result in the data being modified, with possible lethal results. Hence, personal and sensitive data on telemedicine and medical information systems should be encrypted to protect patients from these risks. Login passwords, personal identification information, and biological information should similarly be protected in a systematic way. This paper proposes the use of electronic acupuncture with a built-in multi-pad, which has the advantage of being able to establish a patient's physical condition, while simultaneously treating the patient with acupuncture. This system implements a sensing pad, amplifier, a small signal drive circuit, and a digital signal processing system, while the use of a built-in fuzzy technique and a control algorithm have been proposed for performing analyses.

• Journal of Periodontal and Implant Science
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• 제45권1호
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• pp.23-29
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• 2015

Purpose: This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). Methods: The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. Results: A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). Conclusions: Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.

• 전기학회논문지
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• 제60권1호
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• pp.167-173
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• 2011

Most of the terminologies used in medical domain is not intended to be applied directly in clinical setting but is developed to integrate the terms by defining the reference terminology or concept relations between the terms. Therefore, it is needed to develop the subsets of the terminology which classify categories properly for the purpose of use and extract and organize terms with high utility based on the classified categories in order to utilize the clinical terms conveniently as well as efficiently. Moreover, it is also necessary to develop and upgrade the terminology constantly to meet user's new demand by changing or correcting the system. This study has developed a mapping tool that allows accurate expression and interpretation of clinical terms used for medical records in electronic medical records system and can furthermore secure semantic interoperability among the terms used in the medical information model and generate common terms as well. The system is designed to execute both 1:1 and N:M mapping between the concepts of terms at a time and search for and compare various terms at a time, too. Also, in order to enhance work consistency and work reliability between the task performers, it allows work in parallel and the observation of work processes. Since it is developed with Java, it adds new terms in the form of plug-in to be used. It also reinforce database access security with Remote Method Invocation (RMI). This research still has tasks to be done such as complementing and refining and also establishing management procedures for registered data. However, it will be effectively used to reduce the time and expenses to generate terms in each of the medical institutions and improve the quality of medicine by providing consistent concepts and representative terms for the terminologies used for medical records and inducing proper selection of the terms according to their meaning.

• Vascular Specialist International
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• 제34권4호
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• pp.88-93
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• 2018

Purpose: This study aimed to compare surgical revisions and balloon angioplasty after surgical thrombectomy on thrombosed dialysis access as a first event. Materials and Methods: Records of patients undergoing creation of arteriovenous grafts (AVGs) at the Gachon University Gil Medical Center between March 2008 and February 2016 were reviewed. Among them, patients who underwent treatment on first-time thrombotic occlusion after AVG creation were identified. Outcomes were primary, primary-assisted, and secondary patency. The patency was generated using the Kaplan-Meier method, and patency rates were compared by log-rank test. Results: A total of 59 de novo interventions (n=26, hybrid interventions; n=33, surgical revisions) for occlusive AVGs were identified. The estimated 1-year primary patency rates were 47% and 30% in the surgery and hybrid groups, respectively. The estimated primary patency rates were not different between the two groups (log-rank test, P=0.73). The Kaplan-Meier estimates of 6 and 12 months for primary-assisted patency rates were 68% and 57% in the surgery group and 56% and 56% in the hybrid group. The Kaplan-Meier estimates of 12 and 24 months secondary patency rates were 90% and 71% in the surgery group and 79% and 62% in the hybrid group. There were no differences in the estimated primary-assisted and secondary patency rates between the two groups. Conclusion: Our results showed no significant difference between the two groups in terms of primary patency (P=0.73), primary-assisted patency (P=0.85), and secondary patency (P=0.78). However, percutaneous transluminal angioplasty can give more therapeutic options for both surgeons and patients.

• 한국융합학회논문지
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• 제10권10호
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• pp.259-266
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• 2019

본 연구는 의료 환경의 변화로 병원의 경쟁력을 갖추기 위하여 병원의 행정전략에 대한 변화의 필요성이 있으며, 의료서비스 향상을 위해서 어떤 전략이 가장 중요한지 제시하여, 의료서비스 향상을 위한 병원 행정전략에 기초자료를 제공하고자 한다. 이를 위해서 병원행정 분야와 관련된 행정학 및 경영학 박사급 전문가 20명을 선정하였고, 자료분석방법은 AHP 방법으로 상대적 중요도를 측정하였다. 이에 대한 연구결과는 다음과 같다. 첫째, 측정영역에서 의료서비스 향상을 위한 병원 행정전략에 대한 상대적 중요도는 의료진 요인(1순위), 제반시설 요인(2순위), 직원서비스 요인(3순위), 접근편의 요인(4순위) 순으로 결과가 나타났다. 둘째, 복합가중치 분석 결과, 의료진 전문성(1순위), 의료진 다양성(2순위), 의료장비수준(3순위) 순으로 상대적 중요도가 측정되어 의료서비스 향상을 위한 병원 행정전략은 의료진의 전문성 확보, 의료진의 다양성, 그리고 의료장비 수준을 높이는 것이 가장 중요함을 알 수 있다. 이러한 결과가 의료서비스를 향상시키기 위한 병원의 행정전략 마련 시에 유용한 기초자료로 활용될 수 있을 것이며, 또한 향후 병원 행정전략 마련 시에 다각적인 요소들을 파악해야 할 것이다.