• Korean Journal of Artificial Intelligence
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• v.11 no.2
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• pp.39-44
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• 2023

The creativity of thesis is that the significance of cyber security challenges in blockchain. The variety of enterprises, including those in the medical market, are the targets of cyberattacks. Hospitals and clinics are only two examples of medical facilities that are easy targets for cybercriminals, along with IoT-based medical devices like pacemakers. Cyberattacks in the medical field not only put patients' lives in danger but also have the potential to expose private and sensitive information. Reviewing and looking at the present and historical flaws and vulnerabilities in the blockchain-based IoT and medical institutions' equipment is crucial as they are sensitive, relevant, and of a medical character. This study aims to investigate recent and current weaknesses in medical equipment, of blockchain-based IoT, and institutions. Medical security systems are becoming increasingly crucial in blockchain-based IoT medical devices and digital adoption more broadly. It is gaining importance as a standalone medical device. Currently the use of software in medical market is growing exponentially and many countries have already set guidelines for quality control. The achievements of the thesis are medical equipment of blockchain-based IoT no longer exist in a vacuum, thanks to technical improvements and the emergence of electronic health records (EHRs). Increased EHR use among providers, as well as the demand for integration and connection technologies to improve clinical workflow, patient care solutions, and overall hospital operations, will fuel significant growth in the blockchain-based IoT market for linked medical devices. The need for blockchain technology and IoT-based medical device to enhance their health IT infrastructure and design and development techniques will only get louder in the future. Blockchain technology will be essential in the future of cybersecurity, because blockchain technology can be significantly improved with the cybersecurity adoption of IoT devices, i.e., via remote monitoring, reducing waiting time for emergency rooms, track assets, etc. This paper sheds the light on the benefits of the blockchain-based IoT market.

• Radiation Oncology Journal
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• v.33 no.4
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• pp.337-343
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• 2015

Purpose: The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. Materials and Methods: The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. Results: The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. Conclusion: The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.41-44
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• 2010

Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.180-187
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• 2016

Purpose: This study described the post-exposure prophylaxis (PEP) and secondary varicella infection in children inadvertently exposed to varicella zoster virus (VZV) in the hospital. Methods: We retrospectively analyzed data from patients with VZV infection who were initially not properly isolated, as well as children exposed to VZV at the Seoul National University Children's Hospital between January 2010 and December 2015. The PEP measures were determined by the presence of immunity to VZV and immunocompromising conditions. Patient clinical information was reviewed via medical records. Results: Among 147 children hospitalized between 2010 and 2015, 13 inadvertent exposures were notified due to VZV infection. Five index children had a history of VZV vaccination. Eighty-six children were exposed in multi-occupancy rooms and 62.8% (54/86) were immune to VZV. The PEP measures administered to 27 exposed patients included varicella zoster immunoglobulin and VZV vaccination. Four children developed secondary varicella, which was linked to a single index patient, including one child who did not receive PEP and three of the 27 children who received PEP. The rates of secondary varicella and prophylaxis failure were 4.7% (4/85) and 11.1% (3/27), respectively. The secondary varicella rates were 1.9% (1/54) and 9.7% (3/31) among immunocompetent and immunocompromised children, respectively. Conclusions: Delayed diagnosis of VZV infection can lead to unexpected exposure and place susceptible children and immunocompromised patients at risk for developing varicella. The appropriateness of the current PEP strategy based on VZV immunity may require re-evaluation.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.45-49
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• 2019

Purpose Lung Ventilation Scan(LVS) images directly inhaled radiation gas to evaluate lung ventilation ability. Therefore, it is influenced by various factors related to inhalation, including number of breaths, respiratory duration, respiration rate, and breathing method. In actual LVS examinations, it is difficult for objectify the patient's ability to inhale, and there is currently no known index related to inhalation. Therefore, this study confirms the correlation between counts per second(cps) in LVS and the results of pulmonary function test(PFT) and evaluate its usefulness as an objective indicator of inhalation. Materials and Methods From October 2010 to September 2018, 36 Chronic Obstructive Pulmonary Disease(COPD) patients who had both LVS and PFT were classified by severity(Mild, Moderate, Severe). LVS was performed by creating Technegas with Vita Medical's Technegas Generator and inhaling it to the patient. LVS images were acquired with Philips's Forte equipment., and PFT used Carefusion's Vmax Encore 22. The correlation between the cps measured by setting the region of interest(ROI) of both lungs on the LVS and the forced vital capacity(FVC), forced expiratory volume in one second($FEV_1$), $FEV_1/FVC$ of the results of PFT was compared and analyzed. Results We analyzed the correlation between cps of LVS using Technegas and the results of PFT by classifying COPD patients according to severity. Correlation coefficient between $FEV_1/FVC$ and cps was Severe -0.773, Moderate -0.750, and Mild -0.437. The Severe and Modulate result values were statistically significant(P<0.05) and Mild was not significant(P=0.155). On the other hand, the correlation coefficient between FVC and cps was statistically significant only in Mild and it was 0.882(P<0.05). Conclusion According to the study, we were able to analyze correlation between cps of LVS using Technegas and the results of PFT in COPD Patients. Using this result, when performing a LVS, the results of PFT can be used as an index of inhaling capacity. In addition, it is thought that it will be more effective for the operation of the exam rooms.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.28-34
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• 2010

Purpose: According to increment of thyroid cancer recently, patients of high dose radioiodine therapy were accumulated. Taking into consideration the acceptance capability in the current facility, this study is to calculate the maximum value of high dose radioiodine therapy in patients for treatment. Materials and Methods: The amount and radioactivity of waste water discharged from high dose radioiodine therapy in patients admitted at present hospital as well as the radiation density of the air released into the atmosphere from the high dose radioiodine therapy ward were measured. When the calculated waste water's radiation and its density in the released air satisfies the standard (management standard for discharge into water supply 30 Bq/L, management standard for release into air 3 $Bq/m^3$) set by the Ministry of Education, Science and Technology, the maximum value of treatable high dose radioiodine therapy in patients was calculated. Results: When we calculated in a conservative view, the average density of radiation of waste water discharged from treating high dose radioiodine therapy one patient was 8 MBq/L and after 117 days of diminution in the water-purifier tank, it was 29.5 Bq/L. Also, the average density of radiation of waste water discharged from treating high dose radioiodine therapy two patients was 16 MBq/L and after 70 days of diminution in the water-purifier tank, it was 29.7 Bq/L. Under the same conditions, the density of radiation released into air through RI Ventilation Filter from the radioiodine therapy ward was 0.38 $Bq/m^3$. Conclusion: The maximum value of high dose radioiodine therapy in patients that can be treated within the acceptance capability was calculated and applied to the current facility, and if double rooms are managed by improving the ward structure, it would be possible to reduce the accumulated treatment waiting period for radioiodine therapy in patients.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.549-556
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• 2017

This study compared the spatial scattered dose distribution according to whether the recently developed radiation shielding is used or not in order to understand the spatial scattered dose distribution of C-arm. The horizontal side distribution increased by $30^{\circ}$ in the interval of the radius 50 cm on the height of 95 cm based on the head of the patient, and it was measured by increasing $30^{\circ}$ with the interval of 50 cm in the vertical side of each horizontal side. In the same method, the radiation shielding was installed and measured. The result of measurement shows that the horizontal side of 50 cm distance was $0^{\circ}$, $90^{\circ}$ and $180^{\circ}$, was $1.77{\pm}0.12$, $1.90{\pm}0.13$, $2.12{\pm}0.14$, and $2.69{\pm}0.15mSv/h$ in the $270^{\circ}$ direction, and was $1.59{\pm}0.12$, $0.99{\pm}0.09$, $1.47{\pm}0.11$, and $1.37{\pm}0.11mSv/h$ after the use of the radiation shielding. In addition, the vertical distribution in horizontal direction $90^{\circ}$ with 50 cm distance was $30^{\circ}$, $60^{\circ}$, $120^{\circ}$, was $3.85{\pm}0.18$, $9.15{\pm}0.28$, $10.82{\pm}0.31$, and $5.40{\pm}0.22mSv/h$ in $150^{\circ}$, and was $2.03{\pm}0.13$, $4.32{\pm}0.19$, $2.76{\pm}0.16$, and $1.92{\pm}0.13mSv/h\;mR/h$ after the use of the radiation shielding. Both direction showed decrease according to the use of the radiation shielding. Therefore, radiation related workers who work in operating rooms should recognize the spatial scattered dose distribution exactly and need to try to prevent the risk of radiation exposure with proper protective measures.

• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

• Korea Science and Art Forum
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• v.36
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• pp.391-400
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• 2018

To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.157-166
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• 2000

Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.