• 한국컴퓨터정보학회논문지
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• 제25권12호
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• pp.45-53
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• 2020

본 연구의 목적은 요양병원에서 발생할 수 있는 노인안전사고 발생률을 감소시키는 것이다. 즉, 위험지역으로 접근하는 인물이 노인(환자복) 그룹인지 실무자(평상복) 그룹인지를 CCTV에 나타나는 의복을 기준으로 구별하는 것이다. Web Crawling기법과 요양병원으로부터 지원을 받아 기초 데이터를 수집하였다. 이후 Image Generator와 Labeling으로 모델 학습 데이터를 만들었다. CCTV의 제한된 성능 때문에 높은 정확도와 속도를 모두 갖춘 모델을 만드는 것은 어려웠다. 그러므로 정확성이 상대적으로 우수한 ResNet 모델, 속도에서 상대적으로 우수한 YOLO3 모델을 각각 구현했다. 그리고 요양병원이 자신의 실정에 맞는 모델을 고를 수 있게 하고자 했다. 연구 결과 환자복과 평상복을 적절한 정확도로 구별할 수 있는 모델을 구현하였다. 따라서 실제 사용처에서 노인들이 위험구역에 접근하지 못하도록 하여 요양병원 안전사고 감소에 이바지 할 것으로 평가된다.

• 한국의류학회지
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• 제21권5호
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• pp.854-864
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• 1997

This study was initiated to develop a uniform design suitable for child inpatients. The experimental hospital inpatient uniform design was developed based on the results of the prior studies. The panel was composed of 5 experienced nurses and 5 clothing specialists. They evaluated the function of the experimental inpatient uniforms developed in this study. The experimental hospital gown design was reformed based on the panel's evaluation.1'hen the child inpatients performed the wear test for the reformed experimental hospital gown. The results of the study are as follows; 1. The child inpatient hospital gown design of the most hospitals were similar to the adult patient's uniform : the V-neckline shirts with full length set-in sleeves. The bottom was full length pull-on pants. The fabric was white cotton with blue hospital logo and stripe print in most cases. 2. The panel's specialty affected the evaluation of the uniform design. The nurses concerned about the durability after washing and ease for medical treatment. The clothing specialists cared about the features related to the clothing construction and ease for physical movement of body. 3. The most preferred hospital inpatient uniform design by the panels was the shirts or one- piece gown with three-quarter length sleeve and overarm seam opening. 4. The researchers developed one-piece dress gown for the children under two years old. Three different size pajamas were developed for children 2∼5 years old,5∼8 years and 8∼12 years old.

• 대한두경부종양학회지
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• 제13권1호
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• pp.81-85
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• 1997

Basal cell adenocarcinoma is a rare, recently described neoplasm of the salivary gland. We have experienced three cases of basal cell adenocarcinoma of the parotid gland. The tumors from patient 1 and patient 2 showed intraparotid growth in superficial lobe without cervical lymphnode metastasis. So, patient 1 and patient 2 underwent only a superficial parotidectomy and subdigastric lymphnode dissection without any adjuvant therapy. They are alive without recurrence or distant metastasis. But that of patient 3 showed widely invasive growth with multiple cervical lymph node metastases. The CT scan showed a $8{\times}7cm$ sized huge mass replacing the parotid gland with irregular margin and multiple lymphnode enlargements along the internal jugular vein. Total parotidectomy with sacrifying the facial nerve and standard radical neck dissection were caried out. Microscopically, the tumor consisted of solid nest and sheet of uniform basaloid cells separated by a fibrous connective tissue stroma with the evidence of lymphovascular invasion. As a result of the lymphnode metastasis and invasiveness of the tumor, radiation therapy was given postoperatively. We thought that close follow-up would be mandatory in this patient because of high risk of possible local recurrence and distant metastasis.

• 핵의학기술
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• 제16권2호
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• pp.12-17
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• 2012

방사성 요오드 치료병실에서 나온 환의 및 시트는 본디 방사성폐기물로서 관련 규정에 따라 일반 쓰레기와 동일하게 처리해야 하지만 사정상 일정기간 보관하여 방사능을 감쇄시킨 후 재사용하게 된다. 통상 최소보관기간 산출에 표면오염도(Bq/$m^2$)를 기반으로 하는 반출기준을 적용하고 있다. 하지만 방사선측정기를 이용하여 단위 면적당 총방사능량을 구하는 방법은 측정방법에 따라 편차와 불확실성이 상당히 커진다. 본 연구에서는 '방사성폐기물 자체처분 등에 관한 규정'에서 제시하고 있는 핵종 농도(Bq/g)를 Dose Calibrator를 이용하여 직접 측정하여 최소보관기간을 구함으로써, 환의 및 시트의 정확한 재사용 주기를 산출하고자 한다. 한편 반출기준으로 산출한 최소보관기간과 비교하여 그 차이를 살펴보았다. 본원의 방사성 요오드 치료병실에서 2011년 7월부터 2012년 3월까지 I-131을 3.7 GBq (100 mCi) 이상을 사용하여 방사성 요오드 치료를 시행한 환자 31명이 사용한 환의와 시트의 방사선 오염도를 측정하여 최소보관기간을 산출하였다. 최소보관기간은 핵종 농도를 측정하여 '방사성폐기물 자체처분 등에 관한 규정'에 따라 100 Bq/g이 되는 시점과 표면오염도를 측정하여 반출기준에 따라 허용표면오염도의 1/10, 즉 4 kBq/$m^2$되는 시점을 붕괴식에 대입하여 산출하였다. 반출기준으로 산출한 최소보관기간은 침대/담요시트는 14.2일, 베개시트는 4.6일, 환의(상(上))은 63일, 환의(하(下))는 78일 이었으며, 자체처분 기준에 따른 최소보관기간은 베개시트는 18.1일, 환의(상(上))은 43일, 환의(하(下))는 62일로 산출되었다. 표면오염도와 핵종 농도의 상관관계를 분석해 본 결과 베개시트와 환의(상(上))는 상관관계가 높게 나타났으나, 환의(하)는 낮게 나타났다. 이는 베개시트와 환의는 방사성오염이 부분에 국한 되어 측정값이 일정한 반면, 환의(하(下))는 소변에 의한 방사성오염이 여러 부분에 산재되어 있어 방사선측정기의 측정값이 상대적으로 낮게 측정된 결과로 생각 된다. 실질적으로 방사성 오염도를 측정한 결과 반출기준과 자체처분 기준을 상당량 초과하는 방사능이 존재하는 것을 확인할 수 있었다. 환의와 시트의 최소보관기간 산출에는 핵종 농도를 기준으로 하는 자체처분 기준을 적용하는 것이 더 적합하다고 할 수 있다. 방사능에 오염된 환의 및 시트는 최소 60일 정도는 보관해야 성급한 재사용에 따른 불필요한 방사선피폭 및 오염 확산을 방지할 수 있을 것으로 생각된다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.214-215
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• 2002

Generally uniform dose distribution is assumed to be formed in a target region when a conventional dose formation method using a broad proton beam, a fixed modulation technique, a bolus and an aperture is employed. However, actual situations differ. We usually find non-uniformity in the target region. This is due to the insertion of a range-compensating bolus before the patient. Since the range-compensating bolus has an irregular shape, the scattering in the bolus depends on the lateral position. Dose distribution is overlapping results of dose distribution of pencil-proton beams traversing different lateral positions of the bolus. The lateral extent of dose distribution of each pencil beam traversing the different position differs each other at the same depth in the target object. This is a cause of the non-uniformity of the dose distribution. Therefore the same lateral extent of dose distribution should be attained for different pencil beams at the same depth to obtain a uniform dose distribution. For that purpose, we propose here a bi-material bolus. The bi-material bolus consists of a low-Z material determining mainly the range loss and a high-Z material defining mainly the scattering in the bolus. After passing through the bi-material bolus, protons traversing different lateral positions will have different residual range yet with the same lateral spread at a certain depth. Using the optimized bi-material bolus, we can obtain a more uniform dose distribution in the target region as expected.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2002년도 학술대회지
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• pp.699-702
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• 2002

Shunt valves implanted in the subcutaneous tissue of brain to treat patient with hydrocephalus were numerically simulated to investigate influence of pressure pulsation on their flow control characteristics. Shunt valves are subjected to pressure variation since ventricles enclosing the brain are under pressure pulsation rather than uniform pressure due to blood pressure variation. We modeled flow orifice through shunt valve and imposed pulsating pressure and valve diaphragm movement to compute flow through the valve. The results of our study indicated that flow rate increased by $40{\%}$ by introducing pressure pulsation and diaphragm movement on the shunt valve. Our results demonstrate the pressure-flow control characteristics of shunt valves unplanted above human brain may be quite different from the characteristics obtained by syringe pump test with uniform pressure and no diaphragm movement.

• Archives of Plastic Surgery
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• 제46권3호
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• pp.189-197
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• 2019

There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for office-based cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating "the patient" into the surgical decision-making process through decision aids.

• 대한간호학회지
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• 제23권4호
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• pp.631-648
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• 1993

This study is a descriptive study to provide basic data related to types of uniforms worn by nurses. Nurses, other medical center personnel, patients and their famillies were asked for their opinion on changing nurses’ uniforms and how the image of nurses is 1 elated to the type of uniform worn by the nurses. The data for this study were collected during the period from Feb. 25, 1993 to Mar. 26, 1993 at Y-University Medical Center from 132 nurses, 137 other medical center personnel, 117 patients and their families. The instruments used for this study were the Nurses’ Image Scale(NIS) developed by Bown(1986), and an instrument to measure opinions of uniform and cap using photographs of nurses’ uniforms that was developed by the researcher through a literture review. Data were analyzed using the SPPS / PC package, Statistics used for analysis were frequencies, percentages, paired t -test, and oneway ANOVA The results of this study are summarized as follows ; 1. Of the nurses, 84.3%, along with, 51.5% of the medical center personnel, 39.1% of the patients and their families agreed to a change in the color of nurses uniforms. 2. Similarly, 87.4% of the nurses,27.7% of the medical center personnel, 19.3% of the patients and their families were in favor of nurses not wearing caps. 3. Only 11.8% of nurses answered that a white uniform was important to the professional image of nursing. Only 2.4% of the nurses answered that a cap was very important to the professional image of nursing. 4. Only 1.6% of the nurses answered that a white uniform and cap were important to show the role of nurses in the twenty first century. 5. About 1/3, 36.5%, of the medical center personnel, the patient and their families answered that changing the color of the nurses' uniform will make a change in the image of nurses. 6. A White uniform and cap were seen as being im-portant in distinguishing nurses from other medical personnel in the hospital by 76.5% of the medical personnel, the patients and their families. 7. Nurses gave high marks to the idea of no cap regardless of the color of the uniform which would still portray the symbol of the nurses’ role, identity and would differentiate the role from other jobs. The patients and their families gave high marks to a white uniform with cap. 8. Generally, nurses, medical center personnel and patients and their families thought that a colored uniform with cap presented a good image of nurses. 9. There was a significant difference in the response among the three groups(F=24.65, P〈.001) to the figure in a white uniform with a cap, and the patients and their families thought it was the best portrayal of the image of nurses. There was a significant difference among the three groups(F=9.03, P〈.001) to the figure in a white uniform with no cap and the nurses indicated that it was the beat portrayed of the image of nurses. There was no significant difference among the three groups to the figure in a colored uniform with cap. There was a significant difference(F=17.50, P〈. 001) to the figure in a colored uniform with no cap, and the nurses indicated that it was the best portrayal of the image of nurses. In summary, the nurses wanted to change the color of uniform and not to wear a cap. But many of the medical center personnel, patients and their families indicated they did not agree with this idea. Therefore, changing the type of uniform worn by nurses should be done only after consideration has been given to the relation of the change to the professional role of nurses and the image of nurses held people in general. Suggestions arising from this study are as follows : 1. The relation between the role of nurses and their uniform was surveyed, and these results can be used as data when considering a change in uniforms. 2. A change in uniforms should be tried based on the norm established about uniforms. 3. The nurses did not want to wear a cap, but before a decision is definitely made it is necessary to study the philosophy related to the symbol of the cap because the figure of a nurse with a cap portrayed a positive image of the nurses. If the cap is kept, the symbol of the cap should be redefined. 4. In this study, only the image related to the uniform was examined, but in future studies it will be necessary to examine the practicality of various types of uniforms.

• 의료법학
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• 제14권1호
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• pp.355-401
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• 2013

The first legislation for terminal health-care decision was California's Natural Death Act (NDA) of 1976 that permitted any adult person to execute a directive directing the withholding or withdrawal of life-sustaining procedures. Advance directive legislation has subsequently progressed on a state-by-state basis. By 1992, all 50 states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive. This state legislation, however, has resulted in an often fragmented, incomplete, and sometimes inconsistent set of rules. Statutes enacted within a state often conflict and conflicts between statutes of different states are common. In an increasingly mobile society where an advance health-care directive given in one state must frequently be implemented in another, there is a need for greater uniformity. In 1993, the Uniform Law Commissioners approved the Uniform Health-Care Decisions Act (UHCDA) in order to bring order to the existing chaos. Unfortunately, the Commissioners waited too long to act. By the time the UHCDA was approved, nearly all states had passed legislation governing advance directives. Consequently, the UHCDA has achieved only a limited success, picking up but one or two enactments a year. The UHCDA is currently in effect in around 10 states: Alabama, Alaska, California, Delaware, Hawaii, Kansas, Maine, Mississippi, New Mexico, Tennessee, Wyoming. In these states the previous laws related to the subjects have been all repealed. The overall objective of the UHCDA is to encourage the making and enforcement of advance health care directives including living will or individual instruction, power of health-care attorney and to provide a means for making health care decisions for those who have failed to plan. The U. S. House of Representatives in 1991 enacted the Patient Self-Determination Act (PSDA). The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. Now in America, terminal health-care decision or advance directive for health care is common and universal system. The problem, however, is how to let more people use these good tools to make their lives more beautiful and honorable.

• 한국의학물리학회지:의학물리
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• 제28권1호
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• pp.33-38
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• 2017

Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.