• Journal of the Korea Society of Computer and Information
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• v.25 no.2
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• pp.93-103
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• 2020

The telecare medical information system (TMIS) supports convenient and rapid health-care services. A secure and efficient authentication and key agreement scheme for TMIS provides safeguarding electronic patient records (EPRs) and helps health care workers and medical personnel to rapidly making correct clinical decisions. Giri et al. proposed an RSA-based remote user authentication scheme using smart cards for TMIS and claimed that their scheme could resist various malicious attacks. In this paper, we point out that their scheme is still vulnerable to lost smart card attacks and replay attacks and propose an improved scheme to prevent the shortcomings. As compared with the previous authentication schemes for TMIS, the proposed scheme is more secure and practical.

• The Transactions of the Korean Institute of Electrical Engineers C
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• v.54 no.8
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• pp.378-383
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• 2005

We report the development of miniature fluorescence detection systems that employ miniature prism, mirrors and low coat CCD camera to detect the fluorescence emitted from 40 fluorescently-labeled protein patterns without scanner. This kind of miniature fluorescence detection system can be used in point of care. We introduce two systems, one uses prism+mirror block and the other uses prism and two mirrors. A large NA microscope eyepiece and low cost CCD camera are used. We fabricated protein chip containing multi-pattern BSA labeled with Cy5, using MEMS technology and modified the surface chemically to clean and to immobilize proteins. The measurements show that the combination of prism and mirrors can homogenize elliptical excitation light over the sample with higher optical efficiency, and increase the separation between excitation and fluorescence light at the CCD to give higher signal intensity and higher signal to noise ratio. The measurements also show that protein concentrations ranging from 10 ng/ml to 1000 ng/ml can be assayed with very small error. We believe that the proposed fluorescence detection system can be refined to build a commercially valuable hand-held or miniature detection device.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.663-670
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• 2018

Objective: Radio-contrast abdomino-pelvic computed tomography (APCT) is considered the gold standard diagnostic tool for an acute abdomen in the emergency department. On the other hand, APCT has a risk of contrast-induced nephropathy. Emergency physicians evaluate the creatinine (Cr) level prior to taking a APCT for the above reason but it takes time to evaluation the serum Cr level. This study hypothesized that Cr measured by a point-of-care test (POCT) can shorten the time to making clinically important decisions for patients with an acute abdomen. Methods: This prospective randomized study was conducted between March 2017 and October 2017. The subjects were divided into two groups (Cr measured by laboratory vs. Cr measured by POCT). To analyze the clinical acceptability for creatinine, agreement was demonstrated graphically by Bland-Altman plots. This study compared the time to make a clinically important decision by physicians and the length of stay at the emergency department in both groups. Results: A total of 76 patients were eligible for the study, 38 patients were assigned to each group. There was no statistically significant difference in the time to the first medical examination (P=0.222) and emergency department stay time (P=0.802). On the other hand, the time to recognition of the Cr level (P<0.001), time to performing APCT (P<0.001), time to decision making (P<0.001), and time to initiation of treatment (P<0.001) were shortened significantly in the point-of-care creatinine group. Conclusion: In this study, the POCT for creatinine can allow rapid decision making by shortening the time to performing the radio-contrast APCT than the laboratory for patients with an acute abdomen.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.6
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• pp.367-373
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• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.88-104
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• 2024

Purpose: This study explored the suitability of interventions for medication interruption and intervention preferences. Methods: Two rounds of Delphi surveys were conducted with 18 expert panels comprising staff (or charge) nurses, nursing managers, and Quality Improvement (QI) team nurses working in a tertiary general hospital. For 47 situations involving the location of interruption, medication step, and source of interruption, the suitability of three interventions (no-interruption zone, medication safety vest, and education) was evaluated using a 5-point scale. Results: A total of 51 interventions for each situation were found appropriate by satisfying the degree of convergence and consensus. Patients or caregivers, peer nurses, doctors, telephones, and call bells were sources of interruption and were identified as appropriate for the application of interventions. 'Responding to requests and inquiries' by patients or caregivers showed high overall suitability. The nurses' preferred color for the intervention design (no-interruption zone, medication safety vest) is blue text on a yellow background. The priority groups for education related to medication interruptions were patients or caregivers, nurses, and non-nursing staff, in that order. Conclusion: Effective implementation of tailored intervention strategies that consider the specific characteristics of medication interruptions is crucial for mitigating interruptions and enhancing patient safety. Comprehensive educational programs aimed at reducing medication interruptions by improving awareness are necessary. Moreover, future research should evaluate these strategies in clinical settings to ensure their effectiveness in enhancing patient safety.

• Journal of Biomedical Engineering Research
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• v.42 no.3
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• pp.125-142
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• 2021

The POCT (point-of-care test) sensing that has been a fast-developing field is expected to be a next generation technology in health care. The POCT sensors for the detection of proteins, small molecules and especially nucleic acids have lately attracted considerable attention. According to the World Health Organization (WHO), the POCT methods are required to follow the ASSURED guidelines (Affordable, Sensitive, Specific, User- friendly, Robust and rapid, Equipment-free, Deliverable to all people who need the test). Recently, several CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) based diagnostic techniques using the sensitive gene recognition function of CRISPR have been reported. CRISPR/Cas (Cas, CRISPR associated protein) systems based detection technology is the most innovative gene analysis technology that is following the ASSURED guidelines. It is being re-emerged as a powerful diagnostic tool that can detect nucleic acids due to its characteristics that enable rapid, sensitive and specific analyses of nucleic acid. The first CRISPR-based diagnosis begins with the discovery of the additional function of Cas13a. The enzymatic cleavage occurs when the conjugate of Cas protein and CRISPR RNA (crRNA) detect a specific complementary sequence of the target sequence. Enzymatic cleavage occurs on not only the target sequence, but also all surrounding non-target single-stranded RNAs. This discovery was immediately utilized as a biosensor, and numerous sensor studies using CRISPR have been reported since then. In this review, the concept of CRISPR, the characteristics of the Cas protein required for CRISPR diagnosis, the current research trends of CRISPR diagnostic technology, and some aspects to be improved in the future are covered.

• Korean Journal of Adult Nursing
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• v.25 no.6
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• pp.622-632
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• 2013

Purpose: This study was conducted to compare the nurse licensure examination system in Korea with that of the United States (US). Methods: Focus interviews with the administrative staff of the National Council of State Boards of Nursing (NCSBN) were held. two areas were explored in the interviews: the item development process and the general administrative operating procedures. Results: NCLEX-RN items are designed for entry-level practice. The items are subjected to a series of 12 steps including a item writing panel, a content and editorial review, a sensitivity panel, a pre-test, a Differential item functioning panel and a committee review. NCSBN is responsible for the test for registered nurses and one for practical nurses. In contrast the Korean National Health Personnel Licensing Board (KNHPLB) is responsible for nursing is and 21 other health related licensure. Another difference is that in Korea there is no consistent and specialized staff to develop question items. Items are developed by educators who are not active nurses (this last statemtne is not a finding but a point of view usually not given in findings.). Conclusion: Korean nurses form the largest group of health related job categories and the most direct to health care consumers. Therefore, the nursing licensure exam should be acknowledged as the most influential licensure exam in health care services. We recommend a nursing specialized licensing institution to be established with active nurse' participation in item development process to reflect clinical practice into licensure exam.

• Korean Journal of Childcare and Education
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• v.15 no.6
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• pp.21-40
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• 2019

Objective: The purpose of this study is to find the tendencies and differences of mother's child-rearing anxiety before and after their children enter into elementary school, to analyze the factors influencing child-rearing anxiety at each time, and thereby to seek a support plan at the time of transition. Methods: The subjects of this study were 181 mothers who participated in two surveys which were conducted before and after their child entered into elementary school. Results: Firstly, mother's child-rearing anxiety before and after their children's entrance into elementary school was at a middle level, but increased significantly when they experienced their children's transition to elementary school. Secondly, mother's child-rearing anxiety, before their children's entrance into elementary school, was influenced by private education, the collection of educational information, cognitive ability, whether or not to develop a work status change plan, and birth order sequentially. Thirdly, child-rearing anxiety after their children's entrance into elementary school was significantly influenced by child-rearing anxiety before their children's entrance into elementary school and the mother's employment. Conclusion/Implications: This study is meaningful in the point that it suggested the necessity for the cooperation between multiple systems, such as systematic and stepwise parenting education, the importance of offering information to educational institutions and local governments, and for work- family support policy to prioritize children in order to support children's successful transition into elementary school.

• Journal of Digital Convergence
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• v.12 no.7
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• pp.133-145
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• 2014

Recently, Hospital information systems have the large databases by wide range offices for hospital management, health care to improve the quality of care. However, hospital information systems for information security measures are insufficient. Therefore, when we construct the hospital information system, we have to audit the information security measures for them, and we have to manage the ISMS(Information Security Management System) to maintain the information protection level through the risk managements. In this paper, we suggested the hospital information security audit model for the protection of health information privacy by the current hospital information systems, information security management system(ISMS), and hospital information security requirements and threats. We derived the check items compared with ISO27799 reflected the characteristics of the hospital. We classified the security domains as the physical, technical, administrative domain, and derived the check items for information security. We also designed the check lists by mapping the ISO27799 risk management process to improve the security and efficiency simultaneously. Our model by the five-point scale survey of IT experts was verified the suitability with the average of 4.91 points.

• Journal of Sensor Science and Technology
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• v.19 no.6
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• pp.403-420
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• 2010

Nano and micro structure-based biosensors are promising tool for label-free detection of biomolecular interactions with great accuracy. This review gives a brief survey on nano and micro platforms to sense a variety of analytes such as DNA, proteins and viruses. Among incredible nano and micro structure for bio-analytical applications, the scope of this paper will be limited to micro and nano resonators and nanowire field-effect transistors. Nanomechanical motion of the resonators transducers biological information to readable signals. They are commonly combined with an optical, capacitive or piezo-resistive detection systems. Binding of target molecule to the modified surface of nanowire modulates the current of the nanowire through electrical field-effect. Both detection methods have advantages of label-free, real-time and high sensitive detection. These structures can be extended to fabricate array-type sensors for multiplexed detection and high-throughput analysis. The biosensors based on these structures will be applied to lab-on-a-chip platforms and point-of-care diagnostics. Basic concepts including detection mechanisms and trends in their fields will be covered in this review.