• 한국방사선학회논문지
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• 제9권7호
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• pp.467-471
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• 2015

본 연구에서는 L-tube insertion 환자의 흉부 AP 검사 시 tube tip이 환자의 자세나 방사선 조사각에 의해 왜곡되는 정도를 파악하고 정확한 임상정보를 제공하기 위해 검사 시 정확한 tube 각도를 유지하여 영상의 질을 높이고자 하는데 있다. 실험 장비로 SHIMADZU사의 ELMO-T6S를 사용하였으며, Chest phantom의 표면에 1 mm 간격의 눈금격자를 부착한 L-tube를 부착하여 실험을 하였다. 실험영상의 영상 획득 조건은 90 kVp, 4 mAs, SSD 120 cm로 하여 영상을 획득하였다. Phantom position은 table에서 supine, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$로 변화시키고 각 position마다 Head 방향과 Feet 방향으로 수직, ${\pm}5^{\circ}$, ${\pm}10^{\circ}$, ${\pm}15^{\circ}$ 촬영을 하여 영상을 획득하였다. 본 실험 결과로 L-tube tip의 위치는 환자의 자세와 방사선 입사각에 따라 달라지며 환자의 position이 30, 45, $60^{\circ}$일 때 보다 supine 일 때 tip의 위치변화가 적은 것으로 나타났다. 흉부 방사선 검사를 통해 L-tube tip의 정확한 위치를 보고자 할 때 잘못 된 입사각에 의한 영상의 왜곡이 발생하지 않도록 환자의 자세나 입사각을 조정해야 하며, 해당 시술을 확인하는데 정확한 평가 지표로 이용될 수 있도록 임상에서 업무를 수행하는 방사선사들의 세심한 노력이 필요할 것으로 사료된다.

• 대한간호학회지
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• 제27권3호
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• pp.503-509
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• 1997

This study was undertaken to identify optimal head elevation and position in the care of the neurosurgical patient with a cerebral aneurysm. The effects of 0°. 15° and 30° head elevation and three positions (supine, side tying position opposite to the operation site, and side tying position on the same side as the operation site) on ICP was studied in fourteen neurosurgical patients with cerebral aneurysms. The results are as follows : 1. The mean intracranial pressure was significantly lower when the patient's head was elevated at 30° as compared to 0° and 15°. 2. The mean intracranial pressure was significantly lower when the patient was positioned in the supine as compared to side tying position opposite to the operation site and side tying position on the same side as the operation site. The data indicate that head elevation to 30° and the supine position reduce ICP in neurosurgical patients with cerebral aneurysm.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.568-573
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• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• 한국치위생학회지
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• 제15권4호
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• pp.743-750
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• 2015

Objectives: The purpose of the study is to examine the correlation and influencing factors among ethics position, self-esteem, and perception of patient medical information protection in the dental hygiene students. Methods: This is a cross sectional study using the structured questionnaire. A self-reported questionnaire was completed by 202 dental hygiene students using the stratified sampling method from September 1 to November 1, 2013. The questionnaire was modified and complemented from Ethics Position Questionnaire (EPQ). The questionnaire included EPQ, self-esteem, and perception of patient medical information protection. Data were analyzed by independent t-test, one way ANOVA, Duncan's multiple comparison analysis, Pearson's correlation analysis, and stepwise multiple regression analysis using IBM SPSS Statistics 21.0 program. Results: There was a positive correlation among all the variable including idealism position, self-esteem, and perception of patient medical information protection, The factors influencing on the perception of patient medical information protection were idealism position (${\beta}=0.271$, p<0.001) and self-esteem (${\beta}=0.248$, p<0.001). The corrected explanation power of the model was 15.1%. Conclusions: As the idealism position and self-esteem become higher, the perception of patient medical information protection gets higher. Therefore, this study suggests that it is needed to develop and vitalize implement the appropriate programs enhancing ethics consciousness, proper position, and self-esteem in the dental hygiene students receiving the education for their professionalism in the dental hygiene curricula.

• 한국의학물리학회지:의학물리
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• 제24권3호
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• pp.191-197
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• 2013

방사선 치료 시 방사선이 조사되는 동안 환자의 움직임을 모니터링하는 것은 치료의 성공을 결정 하는 중요한 요인이다. 따라서 방사선이 조사되는 동안 환자의 움직임을 실시간으로 감시하고 움직인 치료위치를 자동으로 보정 할 수 있는 시스템을 개발 하였다. 원점을 중심으로 직교하게 위치한 2개의 CCD 카메라를 이용하여 3차원적 환자의 위치를 확인 하고, 틀 맞춘 상호교차 비교법(normalized cross-correlation method)을 이용한 영상 본 맞춤(image pattern matching) 방법을 이용한 환자위치 모니터링 시스템을 개발하였다. CCD카메라로부터 촬영된 영상을 컴퓨터로 전달하여 위치 변화를 정량적으로 분석 하여 빔 켜고 끔(beam on and off)를 위한 방아쇠신호(trigger signal)를 발생시키고, 이동치료대(moving couch)의 모터를 제어할 수 있는 시스템을 개발하였다. 이 시스템은 0.5 mm 이하의 분해능으로 환자의 위치를 자동으로 보정할 수 있었다.

• 동의신경정신과학회지
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• 제18권3호
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• pp.97-112
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• 2007

Objectives : This study aimed for desirable cure through the investigation of The Patient-Doctor Relationship in Eastern Medicine. Methods : Research materials is data of the patient the doctor and the Patient-Doctor Relationship in Eastern Medicine bibliography except medical theory and clinical contents. Results and Conclusion :. 1. Relatively the doctor's position origin from exorcist has it over patient's that. 2. In spite of clinical doctor, Confucian physician have Confucianism and the ethics so they set The Patient-Doctor Relationship in Eastern Medicine essentially. 3. Each of doctor(the doctor-doctor relationship) emphasize the partnership in the Patient-Doctor Relationship. 4. Patient's choice for doctor is source of the Patient-Doctor Relationship basically and the choice are prudent. 5. The patient must carry into practice psychological and body medical affairs related to health preserving 6. For desirable Patient-Doctor Relationship, doctor's inquire is considered with temper and circumstance and a consultation room are also required stability. 7. Poor Patient-Doctor Relationship are come about when patient is not trust doctor, patient is not follow doctor's order and doctor's indifference to patient.

• Korean Journal of Radiology
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• 제2권4호
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• pp.216-221
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• 2001

Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.

• 대한물리치료과학회지
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• 제27권2호
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• pp.88-95
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• 2020

Background: In the present study to investigate the immediate effects of standing position of the trunk stabilization exercise on Guillain-Barre syndrome patient's balance and gait abilities were examined. Design: Case report and conducted as a single-blind. Methods: Standing position of trunk stabilization exercise was conducted for five Guillain-Barre syndrome patient's who met the selection criteria were recruited. The subjects were conducted conservative exercise and trunk stabilization exercise. Conservative exercise was implemented for thirty min, five times for 8 weeks, and trunk stabilization exercise was implemented for 15 min. The participants' balance was measured via force plate (COP), functional reach test (FRT), timed up and go test (TUG), gait was measured using the 10 m walk test, and 6 minute walk test. Results: After training, the change values of the balance and gait ability in the subjects were significantly greater than pre-test. participants showed significant improvements in COP, FRT, TUG, 10 m walk test and 6 minute walk test pre and post the training (p<0.05). Conclusions: standing position of the trunk stabilization exercise was effective on Guillain-Barre syndrome patient's balance (COP, FRT, TUG) and gait (10 m walk test and 6 minute walk test) abilities were examined.

• 대한방사선기술학회지:방사선기술과학
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• 제38권1호
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• pp.1-6
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• 2015

Whole spine scanography(WSS)는 전신에 X선을 조사하는 검사로 치료기간 동안 빈번한 X선 조사가 이루어지는 검사이다. 일반촬영 분야에서는 많은 X선이 전신에 조사되는 검사이다. 따라서 논문에서는 Auto image pasta기법의 디지털 WSS 검사에서 환자의 검사방향에 따른 유효선량과 장기선량을 전산모사를 통하여 평가하였고, 영상에서 척추의 확대도와 각도의 변화를 평가하였다. 전후면 자세에서의 평균 유효선량은 0.069 mSv였고, 후전면 자세에서 평균 유효선량은 0.0361 mSv로 약 2배의 차이를 보였다. 전후면 자세에서 남성의 평균 유효선량은 0.089 mSv, 여성에 대한 평균 유효선량은 0.431 mSv로 나타났고, 후전면 자세에서 남성의 평균 유효선량은 0.050 mSv, 여성에서는 0.026 mSv로 나타났다. 확대율에서는 후전면 자세에서 전후면 자세에 비해 5%정도 확대 되었으나 각도에는 큰 변화를 보이지 않았다. 따라서 임상 환경에서 동일한 검사조건에서 환자의 자세를 변화시키는 것만으로도 환자의 피폭선량을 감소시킬 수 있음을 확인하였다. 특히 WSS와 같이 치료기간 동안 반복되는 검사에서 환자의 피폭선량 최적화를 위하여 검사 프로토콜의 재정립이 필요함을 확인하였다.

• 기본간호학회지
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• 제19권1호
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• pp.35-45
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• 2012

Purpose: This study was done to explore the relationship between perceived patient safety culture and patient safety management activities among health personnel. Methods: This study was a cross-sectional survey. Participants were 342 health personnel working in two tertiary hospitals. Self-administered questionnaires were used to collect data from a convenience sample of 254 nurses and 88 doctors. Results: Scores on participants' perceived patient safety culture and patient safety management activities were just over the mean. There were significant differences in patient safety management activities by type of occupation, nurses' position, length of service, and work week. Doctors scored perceived patient safety culture and patient safety management activities significantly lower than nurses. In addition, perceived patient safety culture was significantly related to patient safety management activities. Factors which influence participants' patient safety management activities were communication, type of occupation, overall evaluation of patient safety, supervisor/manager, frequency with which events were reported, and nurse's position. Conclusion: Findings provide significant evidence that patient safety management activities are associated with perceived patient safety culture. Therefore, to build a positive safety culture, health personnel, especially doctors and general nurses need to visibly commit to patient safety management activities and be role models to ensure patient safety.